Comparison of Results of Transcatheter Aortic Valve Implantation in Patients With Versus Without Active Cancer - 04/08/16
, Ken Kozuma, MD, PhD a, Hirofumi Hioki, MD a, Hideyuki Kawashima, MD a, Yugo Nara, MD a, Akihisa Kataoka, MD, PhD a, Shinichi Shirai, MD b, Norio Tada, MD c, Motoharu Araki, MD d, Kensuke Takagi, MD e, Futoshi Yamanaka, MD f, Masanori Yamamoto, MD, PhD g, h, Kentaro Hayashida, MD, PhD iAbstract |
The aim of this study was to evaluate postprocedural and midterm outcomes of transcatheter aortic valve implantation (TAVI) in patients with aortic stenosis and active cancer. From October 2013 to August 2015, a total of 749 patients undergoing TAVI using the Edwards Sapien XT prosthesis (Edwards Lifesciences, Irvine, California) were prospectively included in the OCEAN-TAVI registry from 8 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 noncancer 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 noncancer 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 patients with cancer and without cancer (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% CI 1.12 to 20.0; p = 0.035). In conclusion, patients with cancer with severe aortic stenosis who underwent TAVI had similar acute outcomes and midterm survival rates compared with patients without cancer. Cancer metastasis was associated with increased mortality after TAVI.
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Vol 118 - N° 4
P. 572-577 - août 2016 Retour au numéro
Article précédent
- Impact of Different Iterations of Devices and Degree of Aortic Valve Calcium on Paravalvular Regurgitation After Transcatheter Aortic Valve Implantation
- William K.F. Kong, Philippe J. van Rosendael, Frank van der Kley, Arend de Weger, Vasileios Kamperidis, Madelien V. Regeer, Nina Ajmone Marsan, Jeroen J. Bax, Victoria Delgado
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