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Impacto clínico em curto e longo prazo da Válvula Aórtica Percutânea (VAP) em Portugal de acordo com diferentes acessos – Dados do Registo Nacional de Cardiologia de Intervenção de VAP

2020-12Artigo científico Acesso aberto
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dc.contributor.authorGuerreiro, Cláudio
dc.contributor.authorFerreira, Pedro Carrilho
dc.contributor.authorTeles, Rui Campante
dc.contributor.authorBraga, Pedro
dc.contributor.authorCanas da Silva, Pedro
dc.contributor.authorPatrício, Lino
dc.contributor.authorSilva, João Carlos
dc.contributor.authorBaptista, José
dc.contributor.authorde Sousa Almeida, Manuel
dc.contributor.authorGama Ribeiro, Vasco
dc.contributor.authorSilva, Bruno
dc.contributor.authorBrito, João
dc.contributor.authorInfante Oliveira, Eduardo
dc.contributor.authorCacela, Duarte
dc.contributor.authorMadeira, Sérgio
dc.contributor.authorSilveira, João
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.pblSociedade Portuguesa de Cardiologia | Elsevier
dc.date.accessioned2023-01-12T22:15:45Z
dc.date.available2023-01-12T22:15:45Z
dc.date.issued2020-12
dc.description.abstractIntroduction: The Portuguese National Registry of Transcatheter Aortic Valve Implantation records prospectively the characteristics and outcomes of transcatheter aortic valve implantation (TAVI) procedures in Portugal. Objectives: To assess the 30-day and one-year outcomes of TAVI procedures in Portugal. Methods: We compared TAVI results according to the principal access used (transfemoral (TF) vs. non-transfemoral (non-TF)). Cumulative survival curves according to access route, other procedural and clinical variables were obtained. The Valve Academic Research Consortium-2 (VARC-2) composite endpoint of early (30-days) safety was assessed. VARC-2 predictors of 30-days and 1-year all-cause mortality were identified. Results: Between January 2007 and December 2018, 2346 consecutive patients underwent TAVI (2242 native, 104 valve-in-valve; mean age 81±7 years, 53.2% female, EuroSCORE-II - EuroS-II, 4.3%). Device success was 90.1% and numerically lower for non-TF (87.0%). Thirty-day all-cause mortality was 4.8%, with the TF route rendering a lower mortality rate (4.3% vs. 10.1%, p=0.001) and higher safety endpoint (86.4% vs. 72.6%, p<0.001). The one-year all-cause mortality rate was 11.4%, and was significantly lower for TF patients (10.5% vs. 19.4%, p<0.002). After multivariate analysis, peripheral artery disease, previous percutaneous coronary intervention, left ventricular dysfunction and NYHA class III-IV were independent predictors of 30-day all-cause mortality. At one-year follow-up, NYHA class III-IV, non-TF route and occurrence of life-threatening bleeding predicted mortality. Kaplan-Meier survival analysis of the first year of follow-up shows decreased survival for patients with an EuroS-II>5% (p<0.001) and who underwent non-TF TAVI (p<0.001). Conclusion: Data from our national real-world registry showed that TAVI was safe and effective. The use of a non-transfemoral approach demonstrated safety in the short term. Long-term prognosis was, however, adversely associated with this route, with comorbidities and the baseline clinical status.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent13
dc.format.extent1519227
dc.identifier.doi10.1016/j.repc.2020.02.014
dc.identifier.issn0870-2551
dc.identifier.otherPURE: 27716010
dc.identifier.otherPURE UUID: f2d83107-caaf-455d-b12d-0e0809a90829
dc.identifier.otherScopus: 85097457188
dc.identifier.otherPubMed: 33261991
dc.identifier.otherWOS: 000605402400007
dc.identifier.urihttp://hdl.handle.net/10362/147428
dc.identifier.urlhttps://www.scopus.com/pages/publications/85097457188
dc.language.isopor
dc.peerreviewedyes
dc.subjectHeart failure
dc.subjectSevere aortic valvular disease
dc.subjectTAVI
dc.subjectCardiology and Cardiovascular Medicine
dc.titleImpacto clínico em curto e longo prazo da Válvula Aórtica Percutânea (VAP) em Portugal de acordo com diferentes acessos – Dados do Registo Nacional de Cardiologia de Intervenção de VAPpt
dc.title.alternativeShort and long-term clinical impact of transcatheter aortic valve implantation in Portugal according to different access routesData from the Portuguese National Registry of TAVIen
dc.typejournal article
degois.publication.firstPage705
degois.publication.issue12
degois.publication.lastPage717
degois.publication.titleRevista Portuguesa de Cardiologia
degois.publication.volume39
dspace.entity.typePublication
rcaap.rightsopenAccess

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