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Emergency transcatheter aortic valve replacement in patients with cardiogenic shock due to acutely decompensated aortic stenosis

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Emergency transcatheter aortic valve replacement in patients with cardiogenic shock due to acutely decompensated aortic stenosis. / Frerker, Christian; Schewel, Jury; Schlüter, Michael; Schewel, Dimitry; Ramadan, Hassan; Schmidt, Tobias; Thielsen, Thomas; Kreidel, Felix; Schlingloff, Friederike; Bader, Ralf; Wohlmuth, Peter; Schäfer, Ulrich; Kuck, Karl-Heinz.

In: EUROINTERVENTION, Vol. 11, No. 13, 20.04.2016, p. 1530-1536.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Frerker, C, Schewel, J, Schlüter, M, Schewel, D, Ramadan, H, Schmidt, T, Thielsen, T, Kreidel, F, Schlingloff, F, Bader, R, Wohlmuth, P, Schäfer, U & Kuck, K-H 2016, 'Emergency transcatheter aortic valve replacement in patients with cardiogenic shock due to acutely decompensated aortic stenosis', EUROINTERVENTION, vol. 11, no. 13, pp. 1530-1536. https://doi.org/10.4244/EIJY15M03_03

APA

Frerker, C., Schewel, J., Schlüter, M., Schewel, D., Ramadan, H., Schmidt, T., Thielsen, T., Kreidel, F., Schlingloff, F., Bader, R., Wohlmuth, P., Schäfer, U., & Kuck, K-H. (2016). Emergency transcatheter aortic valve replacement in patients with cardiogenic shock due to acutely decompensated aortic stenosis. EUROINTERVENTION, 11(13), 1530-1536. https://doi.org/10.4244/EIJY15M03_03

Vancouver

Frerker C, Schewel J, Schlüter M, Schewel D, Ramadan H, Schmidt T et al. Emergency transcatheter aortic valve replacement in patients with cardiogenic shock due to acutely decompensated aortic stenosis. EUROINTERVENTION. 2016 Apr 20;11(13):1530-1536. https://doi.org/10.4244/EIJY15M03_03

Bibtex

@article{b86d0c1c61024421bdec8eed97c6f522,
title = "Emergency transcatheter aortic valve replacement in patients with cardiogenic shock due to acutely decompensated aortic stenosis",
abstract = "AIMS: To assess outcomes of TAVR as a rescue therapy in patients with cardiogenic shock due to acutely decompensated aortic stenosis.METHODS AND RESULTS: Of 771 high-risk patients who underwent TAVR, 27 (3.5%; 78±9 years; 12 men) were treated emergently due to acutely decompensated aortic stenosis with cardiogenic shock. SAPIEN and CoreValve prostheses were implanted in 11 and 16 patients, respectively: the transfemoral access route was used in 25. Three patients died within 72 hours of successful valve deployment, and a further six died within a month, giving a 30-day mortality of 33.3%, which was significantly higher than in electively treated patients (7.7%, p<0.0001). Univariate predictors of 30-day mortality in cardiogenic-shock patients were baseline cardiac output <3.0 l/min, reduced cardiac power index, impaired renal function, and mechanical ventilation, as well as severe acute kidney injury after TAVR. Estimated one-year survival was 59.3% in emergently and 82.7% in electively treated patients (p=0.0009). However, 30-day landmark analysis showed no difference in cumulative survival between TAVR modalities. In cardiogenic-shock patients without concomitant reduced cardiac output and impaired renal function at baseline (n=22), estimated one-year survival was 72.7%.CONCLUSIONS: TAVR should be considered a reasonable rescue therapy in patients with cardiogenic shock secondary to decompensated aortic stenosis.",
keywords = "Aged, Aged, 80 and over, Aortic Valve Stenosis/surgery, Cardiac Catheterization/methods, Female, Heart Valve Prosthesis/adverse effects, Humans, Male, Middle Aged, Risk Factors, Shock, Cardiogenic/surgery, Transcatheter Aortic Valve Replacement/methods, Treatment Outcome",
author = "Christian Frerker and Jury Schewel and Michael Schl{\"u}ter and Dimitry Schewel and Hassan Ramadan and Tobias Schmidt and Thomas Thielsen and Felix Kreidel and Friederike Schlingloff and Ralf Bader and Peter Wohlmuth and Ulrich Sch{\"a}fer and Karl-Heinz Kuck",
year = "2016",
month = apr,
day = "20",
doi = "10.4244/EIJY15M03_03",
language = "English",
volume = "11",
pages = "1530--1536",
journal = "EUROINTERVENTION",
issn = "1774-024X",
publisher = "EUROPA EDITION",
number = "13",

}

RIS

TY - JOUR

T1 - Emergency transcatheter aortic valve replacement in patients with cardiogenic shock due to acutely decompensated aortic stenosis

AU - Frerker, Christian

AU - Schewel, Jury

AU - Schlüter, Michael

AU - Schewel, Dimitry

AU - Ramadan, Hassan

AU - Schmidt, Tobias

AU - Thielsen, Thomas

AU - Kreidel, Felix

AU - Schlingloff, Friederike

AU - Bader, Ralf

AU - Wohlmuth, Peter

AU - Schäfer, Ulrich

AU - Kuck, Karl-Heinz

PY - 2016/4/20

Y1 - 2016/4/20

N2 - AIMS: To assess outcomes of TAVR as a rescue therapy in patients with cardiogenic shock due to acutely decompensated aortic stenosis.METHODS AND RESULTS: Of 771 high-risk patients who underwent TAVR, 27 (3.5%; 78±9 years; 12 men) were treated emergently due to acutely decompensated aortic stenosis with cardiogenic shock. SAPIEN and CoreValve prostheses were implanted in 11 and 16 patients, respectively: the transfemoral access route was used in 25. Three patients died within 72 hours of successful valve deployment, and a further six died within a month, giving a 30-day mortality of 33.3%, which was significantly higher than in electively treated patients (7.7%, p<0.0001). Univariate predictors of 30-day mortality in cardiogenic-shock patients were baseline cardiac output <3.0 l/min, reduced cardiac power index, impaired renal function, and mechanical ventilation, as well as severe acute kidney injury after TAVR. Estimated one-year survival was 59.3% in emergently and 82.7% in electively treated patients (p=0.0009). However, 30-day landmark analysis showed no difference in cumulative survival between TAVR modalities. In cardiogenic-shock patients without concomitant reduced cardiac output and impaired renal function at baseline (n=22), estimated one-year survival was 72.7%.CONCLUSIONS: TAVR should be considered a reasonable rescue therapy in patients with cardiogenic shock secondary to decompensated aortic stenosis.

AB - AIMS: To assess outcomes of TAVR as a rescue therapy in patients with cardiogenic shock due to acutely decompensated aortic stenosis.METHODS AND RESULTS: Of 771 high-risk patients who underwent TAVR, 27 (3.5%; 78±9 years; 12 men) were treated emergently due to acutely decompensated aortic stenosis with cardiogenic shock. SAPIEN and CoreValve prostheses were implanted in 11 and 16 patients, respectively: the transfemoral access route was used in 25. Three patients died within 72 hours of successful valve deployment, and a further six died within a month, giving a 30-day mortality of 33.3%, which was significantly higher than in electively treated patients (7.7%, p<0.0001). Univariate predictors of 30-day mortality in cardiogenic-shock patients were baseline cardiac output <3.0 l/min, reduced cardiac power index, impaired renal function, and mechanical ventilation, as well as severe acute kidney injury after TAVR. Estimated one-year survival was 59.3% in emergently and 82.7% in electively treated patients (p=0.0009). However, 30-day landmark analysis showed no difference in cumulative survival between TAVR modalities. In cardiogenic-shock patients without concomitant reduced cardiac output and impaired renal function at baseline (n=22), estimated one-year survival was 72.7%.CONCLUSIONS: TAVR should be considered a reasonable rescue therapy in patients with cardiogenic shock secondary to decompensated aortic stenosis.

KW - Aged

KW - Aged, 80 and over

KW - Aortic Valve Stenosis/surgery

KW - Cardiac Catheterization/methods

KW - Female

KW - Heart Valve Prosthesis/adverse effects

KW - Humans

KW - Male

KW - Middle Aged

KW - Risk Factors

KW - Shock, Cardiogenic/surgery

KW - Transcatheter Aortic Valve Replacement/methods

KW - Treatment Outcome

U2 - 10.4244/EIJY15M03_03

DO - 10.4244/EIJY15M03_03

M3 - SCORING: Journal article

C2 - 25751886

VL - 11

SP - 1530

EP - 1536

JO - EUROINTERVENTION

JF - EUROINTERVENTION

SN - 1774-024X

IS - 13

ER -