Valvular Heart DiseaseComparison of 1-Year Outcome in Patients With Severe Aorta Stenosis Treated Conservatively or by Aortic Valve Replacement or by Percutaneous Transcatheter Aortic Valve Implantation (Data from a Multicenter Spanish Registry)
Section snippets
Methods
Influencia del Diagnóstico de Estenosis Aórtica Severa (IDEAS)—Influence of the Severe Aortic Stenosis Diagnosis—is a multicenter registry that enrolled all consecutive adults diagnosed with severe AS (mean gradient >40 mm Hg or valve area <1 cm2) in the echocardiographic laboratory of 48 Spanish centers, during January 2014.
The only exclusion was any previous aortic valve intervention, including valvuloplasty, AVR, and TAVI. Informed consent was obtained. Variables registered included clinical
Results
A total of 726 patients were included, mean age was 77.3 ± 10.6 years, and 377 were women (51.8%). The most common management strategy was conservative therapy in 468 (64.5%), followed by AVR in 199 (27.4%), and TAVI in 59 (8.1%). Table 1 lists the comparison of clinical and echocardiographic data according to management. Patients treated with AVR were younger, with less co-morbidity, and lower surgical risk than patients managed without open-heart surgery. They also presented higher creatinine
Discussion
In our population with severe AS, the most common management strategy was conservative therapy. The decision to perform aortic valve intervention was more frequent in tertiary hospitals than in small regional centers. Patients managed with AVR had the lowest risk profile of the 3 groups. TAVI seems to be particularly beneficial for patients with high co-morbidity or high surgical risk.
Recent studies have shown that patients with severe AS are frequently treated conservatively,9, 10, 11, 12 even
Disclosures
The authors have no conflicts of interest to disclose.
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