Table 2.
Clinical characteristics and outcomes of patients treated with transcatheter aortic valve replacement (TAVR) at the Minneapolis VA Healthcare System (MVAHCS)
| MVAHCS TAVR Overall (n=110) |
MVAHCS TAVR patients IR group (n=44) |
|
|---|---|---|
| Age –years (±SD) | 79 (9) | 80 (7) |
| STS score, median (95% CI) | 5 (4–6) | 5.2 (5–8) |
| Men (%) | 108 (98%) | 42 (95.5%) |
| NYHA class III–IV | 68 (61%) | 29 (65%) |
| Previous MI | 17(16%) | 8 (18%) |
| Previous PCI | 28 (26%) | 13 (30%) |
| Previous CABG | 31 (28%) | 15 (34%) |
| HTN | 70 (63%) | 27 (61%) |
| Peripheral arterial disease | 22 (20%) | 8 (18%) |
| Dialysis | 4 (3.6%) | 2 (5%) |
| COPD | 55 (50%) | 20 (45%) |
| Current smoker | 11 (10%) | 5 (11%) |
| Diabetes | 42 (38%) | 15 (34%) |
| Serum creatinine (mg/dl), mean (±SD) | 1.3 (0.9) | 1.1 (0.4) |
| Hemoglobin g/dl (±SD) | 12 (2) | 12 (1.9) |
| Albumin g/dl, mean (±SD) | 3.4 (0.4) | 3.3 (0.5) |
| Weight-Kg, mean (±SD) | 88 (21) | 88 (15) |
| EF %, mean (±SD) | 50 (11) | 49 (12) |
| Procedural Indication | ||
| Pure AS | 96 (88%) | 41 (93%) |
| AS/AI | 4 (3.7%) | 1 (2.3%) |
| Valve in Valve | 12 (11%) | 2 (5%) |
| Transfemoral access | 94 (85%) | 39 (89%) |
| Balloon-expandable valve | 93 (84.5%) | 38 (86%) |
| Device Size | ||
| 23 mm | 18 (16%) | 8 (18%) |
| 26 mm | 41 (37%) | 17 (38%) |
| 29 mm | 46 (41%) | 17 (38%) |
| 31 mm | 5 (4.5%) | 2 (4.5%) |
| Fluoroscopy time -minutes, median (95% CI) | 22 (19–27) | 21 (17–28) |
| Contrast volume –ml, median (95% CI) | 115 (93–138) | 115 (88–144) |
| Monitored anesthesia care (MAC) | 31 (28%) | 17 (40%) |
| Length of stay -days, median (95% CI) | 4 (3–4) | 4 (2–4) |
| Estimated Mortality | 5% | 5.2 % |
| Observed Mortality | 1.9% | 0% |
| Observed/Expected(O/E) mortality ratio | 0.38 | 0.01 (*) |
| TIA/stroke | 3% | 2.3% |
| Disabling stroke | 0% | 0% |
| Death or stroke | 4.9% | 2.2% |
| MI | 0% | 0% |
| Major vascular complications | 1 (0.9%) | 0% |
| New Pacemaker | 18 (16%) | 5 (11%) |
| Second valve | 1 (1.9%) | 0 % |
| Moderate/Severe PVL (% total) | 4/0 (3.6%) | 3/0 (6.8%) |
| Mean gradient- mmHg, median (IQR) | 10 (8–13) | 9 (7–11) |
STS: Society of Thoracic Surgeons, NYHA: New York Heart Association, MI: myocardial infarction, PCI: percutaneous coronary intervention, CABG: coronary artery bypass surgery, HTN: hypertension, COPD: chronic obstructive pulmonary disease, PAD: peripheral arterial disease, TIA, transient ischemic attack, CI: confidence interval
*
Given observed mortality of zero, 0.1 was added to numerator and denominator to allow for this calculation.