Author + information
- S1936879815022402-0e824b6bd196b6c074117d96f588e1f3Edward Koifman,
- S1936879815022402-04922536d0743a257a0e4850a20bd531Romain Didier,
- S1936879815022402-5eb9de0dd9d65ffa48f9e1be394793efFederico Asch,
- S1936879815022402-3ae092fe4694593e647188c3a7b14a4cZachary Jerusalem,
- S1936879815022402-22ca6bb575feb9b0401e73b8ef13bd3aSarkis Kiramijyan,
- S1936879815022402-05002cb46075934f124e1def1fbd79a4Smita Negi,
- S1936879815022402-3a0d6b08f0725219bdf768375029e047Michael Lipinski,
- S1936879815022402-43188b297454714a1e633ce32956ff39Rebecca Torguson,
- S1936879815022402-931563e2cf56fef96b8356fb1cdb589cJiaxiang Gai,
- S1936879815022402-bc417308326f0e29f4cc19e35b7b7822Petros Okubagzi,
- S1936879815022402-280150bfca3f0be2b424079de79e87c6Itsik Ben Dor,
- S1936879815022402-e581276892d3eac6d775a41ed0644866Lowell Satler,
- S1936879815022402-1c8dbbe26ae59aac47c65a3d1f751134Augusto Pichard and
- S1936879815022402-772b1cb1fca98a9f26e1e7f8bddc725bRon Waksman
Right ventricular (RV) function was shown to be associated with adverse outcomes in a variety of cardiac patients and is considered a risk factor for adverse outcome according the updated Valve Academic Consortium Criteria.
Our goal was to assess the impact of RV function at baseline on 1-year mortality among severe aortic stenosis (AS) patients undergoing transcatheter aortic valve replacement (TAVR).
All severe AS patients treated with TAVR from 5/2007 to 11/2014 at our center, were included in the present study, and baseline and procedural characteristics were recorded for each patient. The patients were categorized according to RV function as assessed by current guidelines, and 1-year comparison of mortality rates was performed.
Among 599 patients, 144 (24%) had RV dysfunction. There were significant differences between the 2 groups, as patients with RV dysfunction were younger (81±9 vs. 84±8, p=0.003) and were more likely to be male (64% vs. 43%, p<0.001). In addition, patients with RV dysfunction had higher rates of prior myocardial infarction (29% vs. 16%, p<0.001) and atrial fibrillation (54% vs. 39%, p=0.001). Echocardiographic parameters demonstrated higher rates of ejection fraction <40% (37% vs. 20%, p=0.001), tricuspid regurgitation above moderate (16% vs. 9%, p=0.03) and higher pulmonary artery systolic pressure (50±17 vs. 44±16, p=0.001) among severe AS patients with RV dysfunction compared to patients with normal RV function. Despite the unfavorable cardiac function, severe AS patients undergoing TAVR has similar mortality rates at 1-year (27% vs. 23%, p=0.27).
Severe AS patients with RV dysfunction have similar benefit from TAVR as patients with normal RV function. The presence of RV dysfunction does not correlate with outcome in patients with severe.