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Int J Cardiol. 2015 Mar 15;183:98-104. doi: 10.1016/j.ijcard.2015.01.037. Epub 2015 Jan 30.

Impact of previous acute pulmonary oedema after transcatheter aortic valve implantation: insight from French Aortic National CoreValve and Edwards 2 [FRANCE 2]registry.

Author information

1
CardiologyDepartment HôpitalHenri-Mondor, Assistance-Publique-HôpitauxdeParis & INSERM-U955, 51 Avenue du Maréchal de Lattre de Tassigny, 94000 Creteil, France; Advanced Cardiovascular Therapy Unit, Cardiovascular Surgery Department, Ageo Central General Hospital, 1-10-10 Kashiwaza, Ageo, 362-8588 Saitama, Japan. Electronic address: frtakr@gmail.com.
2
CardiologyDepartment HôpitalHenri-Mondor, Assistance-Publique-HôpitauxdeParis & INSERM-U955, 51 Avenue du Maréchal de Lattre de Tassigny, 94000 Creteil, France.
3
Cardiology Department, Centre-Hospitalier-Universitaire de Brest, Hôpital de la Cavale- Blanche, boulevard Tanguy Prigent, 29609 Brest, France.
4
Cardiac Surgery Unit, Centre-Hospitalier-Universitaire de Limoges, 2 avenue Martin Luther king, 87042 Limoges Cedex, France.
5
Cardiology Department, Centre-Hospitalier-Universitaire de Rouen, 1 rue de Germont, Rouen, France.
6
Cardiology Department, Clinique Pasteur, Centre de recherche cardiologique, 1 rue de la petite vitesse, 31000 Toulouse, France.
7
Cardiology Department, Centre-Hospitalier-Universitaire Xavier Bichat, Université Paris Diderot, 16 rue Henri-Huchard, 75018 Paris, France.
8
Cardiac Surgery Unit, Institut-Cardiovasculaire Paris-Sud, Massy, France.
9
Cardiac Surgery Unit, Centre-Hospitalier-Universitaire Pitié salpêtrière, Université Paris, France.
10
CHU Rennes, Rennes, France, 2 rue Henri le Guilloux, Rennes, France.
11
Cardiac Surgery Unit, Centre-Hospitalier-Universitaire de Lille, 12 rue Jean Jaurès, Lille, France.

Abstract

BACKGROUND:

The prognostic value of previous pulmonary oedema (PO) has not been thoroughly investigated in a large-cohort of TAVI-patients. The aim of this study was to assess the influence of previous clinical history of acute PO in severe aortic stenosis (AS) patients undergoing transcatheter aortic valve implantation (TAVI).

METHODS:

Data were analyzed for 3195 patients enrolled in the French national TAVI registry, FRANCE 2. We compared the clinical outcome of enrolled patients divided broadly into three groups according to the frequency of previous acute PO episode; group 1: no-episode, group 2: single-episode, and group 3: multiple-episodes within the year preceding TAVI.

RESULTS:

Of the 3195 patients (mean age: 82.7 ± 7.2 years, mean logistic-EuroSCORE: 21.8 ± 14.3) with TAVI, 1880 (58.8%) had no-episode, 937 (29.3%) had single-episode, and 378 (11.9%) had multiple-episode. Both 30-day and cumulative 1-year mortality increased significantly across the 3 groups (7.7% vs. 9.2% vs. 15.9%; p<0.001, 14.0% vs. 19.4% vs. 24.1%; p<0.001, respectively). In addition, single-PO was not independently associated with an increased mortality at 30-day and 1-year compared to no-PO (HR: 0.99; 95% CI: 0.75-1.30; p=0.923, HR: 1.15; 95% CI: 0.94-1.39; p=0.173, respectively). In contrast multiple-PO was independently associated with an increased risk of both 30-day and cumulative 1-year mortality (HR: 1.51; 95% CI: 1.10-2.01; p=0.012, HR: 1.30; 95% CI: 1.01-1.66; p=0.043, respectively).

CONCLUSION:

Multiple-PO, but not single, within the year preceding the index procedure is independently associated with increased mortality at short- and mid-term follow up after TAVI.

KEYWORDS:

Prognosis; Pulmonary oedema; Transcatheter aortic valve implantation

PMID:
25662059
DOI:
10.1016/j.ijcard.2015.01.037
[Indexed for MEDLINE]

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