Background
Trans-catheter aortic valve implantation (TAVI) became available at Auckland City
Hospital in 2011 for patients with severe aortic stenosis in whom surgical aortic
valve replacement (AVR) was deemed at high risk. We assessed whether introduction
of TAVI affected the characteristics and outcomes of octogenarians undergoing AVR.
Methods
Isolated AVR performed in patients ≥80 years of age during 2008–2012 were divided
into two groups, pre- and post-TAVI introduction, for analyses.
Results
Isolated AVR was undertaken in 35 and 33 octogenarians pre- and post-TAVI introduction.
The post-TAVI group were older (84.2 vs 82.3 years, P = 0.003), had lower ejection fraction (P = 0.026), more had inpatient surgery (76% vs 29%, P < 0.001), with higher EuroSCORE II (5.4 vs 3.9%, P = 0.033). Operative mortality was 0.0% in both groups. One-year survival was similar
(97.6% vs 94.3%, P = 0.613), but composite morbidity was lower in the post-TAVI group (9.1% vs 31.4%, P = 0.035). Chronic respiratory disease (P = 0.043) independently predicted mortality during follow-up, while number of coronary
vessel > 50% stenosis (P = 0.050), creatinine clearance (P = 0.016) and being in the pre-TAVI era group (P = 0.022) predicted composite morbidity.
Conclusions
Since TAVI was introduced, mean age and risk scores significantly increased in octogenarians
undergoing AVR, while mortality rates remained similar and composite morbidity decreased.
Keywords
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Article info
Publication history
Published online: November 19, 2013
Accepted:
October 17,
2013
Received in revised form:
August 22,
2013
Received:
July 26,
2013
Identification
Copyright
© 2013 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier Inc. All rights reserved.
