Failure is Fatal! Which Determinants of Outcome Remain after Transcatheter Aortic Valve Implantation?

  • #AC/VAL 01-O-4
  • Adult Cardiac Surgery/Valves. SESSION-1
  • Oral

Failure is Fatal! Which Determinants of Outcome Remain after Transcatheter Aortic Valve Implantation?

Markus Mach 1, Manuel Wilbring 2, Konstantin Alexiou 2, Utz Kappert 2, Martin Grabenwöger 1, Klaus Matschke 2

Hospital Hietzing, Department of Cardiovascular Surgery, Vienna, Austria; University Heart Center Dresden, Dresden, Germany;

Date, time and location: 2018.05.26 08:30, Congress Hall, 2F–B



To the present, detailed knowledge about factors predisposing adverse outcomes of high-risk subgroups remains scarce. The present study gives a detailed analysis of a large TAVI cohort.

Patients and Methods

Since 2009, 1.861 consecutive patients underwent TAVI in two study centers. Mean patient’s age was 80.8 +/- 5.6. Mean follow-up was 2.92 years, ranging up to 6.8 years. Data were retrospectively analyzed out of the hospital’s database. A uni- and multivariate analysis of risk factors for mortality during primary hospital-stay and further follow-up was performed.


Hospital mortality was 4.1%. Survival rates for 1-, 2- and 5-years were 96%, 86,8% and 46,2% respectively . Univariate risk factors for hospital mortality were LV-EF <30% (p=0.03), extracardiac arteriopathy (p=0.023), chronic kidney disease (p=0.002), postoperative LCOS (p<0.01), re-exploration (p<0.01), respiratory failure (p<0.01), postoperative stroke (p<0.01), CVVH (p<0.01), prolonged ventilation (p<0.01), transfusion (p<0.01), prolonged ICU-stay (p<0.01). After multivariate analysis respiratory failure needing reintubation (HR 2.3 +/- 0.4; p<0.01), postoperative stroke (HR 1.4 +/- 0.6; p=0.02) and postoperative renal failure needing CVVH (HR 1.1 +/- 0.4; p<0.01) remained as factors for hospital mortality. Univariate risk factors for mortality during follow-up of the hospital survivors were  postoperative stroke (p<0.01), postoperative CVVH (p<0.01), transfusion (p<0.01), postoperative respiratory failure needing reintubation (p<0.01), postoperative stroke (p<0.01). After multivariate analysis pulmonary hypertension (HR 2.8 +/- 0.2; p<0.01) and postoperative stroke (HR 1.7 +/- 0.7; p=0.02) remained as significant factors for mortality during follow-up.


Hospital mortality of TAVI-patients is decoupled from patients baseline characteristics. Significant factors for hospital mortality mainly were generated out of post-procedural complications. Different patterns were observed for long-term survival. Generally, TAVI provides good results in this particular high-risk subgroup. Further investigations are needed to clearly identify patients benefiting or not-benefiting from TAVI.

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