Comparison of Results of Transcatheter Aortic Valve Implantation in Patients with Versus without Active Cancer
Abstract The aim of this study was to evaluate post-procedural and midterm outcomes of transcatheter aortic valve implantation (TAVI) in patients with aortic stenosis (AS) and active cancer. Between October 2013 and August 2015, a total of 749 patients undergoing TAVI using the Edwards Sapien XT pro...
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Published in | The American journal of cardiology Vol. 118; no. 4; pp. 572 - 577 |
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Main Authors | , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Elsevier Inc
15.08.2016
Elsevier Limited |
Subjects | |
Online Access | Get full text |
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Summary: | Abstract The aim of this study was to evaluate post-procedural and midterm outcomes of transcatheter aortic valve implantation (TAVI) in patients with aortic stenosis (AS) and active cancer. Between October 2013 and August 2015, a total of 749 patients undergoing TAVI using the Edwards Sapien XT prosthesis (Edwards Lifesciences, Irvine, California, USA) were prospectively included in the OCEAN-TAVI registry from eight Japanese centers. A total of 47 patients (44.7% men; median age 83 years) had active cancer. The transfemoral approach was implemented in 85.1% of patients in the cancer group and 78.1% in the non-cancer group (p=0.22). The occurrence of major vascular complication (4.3% vs. 7.5%, p=0.24), life threatening bleeding (2.1% vs. 7.1%, p=0.15), and major bleeding (8.5% vs. 13%, p=0.38) was similar between the cancer and non-cancer groups. No significant differences were observed regarding device success (100% vs. 96.2%, p=0.17) or 30-day survival (95.7% vs. 97.3%, p=0.38). No difference in midterm survival was found between the cancer patients and non-cancer patients (Log-rank, p=0.42), regardless of advanced or limited cancer (Log-rank, p=0.68). In a multivariable Cox proportional hazard regression analysis, cancer metastasis was one of the most significant predictors of late mortality (hazard ratio: 4.73; 95% confidence interval: 1.12 to 20.0; p=0.035). In conclusion, cancer patients with severe AS who underwent TAVI had similar acute outcomes and midterm survival rates compared to non-cancer patients. Cancer metastasis was associated with increased mortality after TAVI. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0002-9149 1879-1913 |
DOI: | 10.1016/j.amjcard.2016.05.052 |