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Transcatheter aortic valve implantation (TAVI) has become a valuable alternative to aortic valve replacement (AVR) for surgical high-risk patients with severe aortic stenosis. Due to technical improvements and increased operator experience the valve implantation success has become very high. Nevertheless, the post procedural recovery in these elderly patients is often prolonged. We aimed to evaluate clinical and demographic predictors of a prolonged hospital stay in patients undergoing TAVI.
We included 187 consecutive patients with severe aortic stenosis who underwent TAVI. The valve was implanted by transfemoral technic in 180 (96.3%), transapical in 2 (1.1%) and via the subclavian artery in 5 (2.7%) patients. We implanted 160 (85.6%) CoreValve and 27 (14.4%) Edwards Sapien prostheses. Logistic regression was used to determine the factors affecting length of stay longer than median.
Median of length of stay was 7 days. Pulmonary hypertension above 60mmHg, prior ischemic stroke, EuroSCORE II above median (5.3%) and previous cardiac surgery did not have significant influence on the length of hospital stay (LOS). The following parameters could be identified as predictors of a hospital stay > 7 days (table 1).
Age above 85, STS-Score above median (5.6%), female gender, state of chronic renal failure ≥ 3, logistic EuroSCORE above median (14.7%) are associated with an increased risk of a longer hospital stay after TAVI. Independent predicting risk factors are only the STS Score above median (5.6%) and the age above 85.
- 2013 American College of Cardiology Foundation