: Transcatheter aortic valve implantation (TAVI) has emerged as a pivotal intervention for managing severe aortic stenosis in high-risk surgical patients. : This study aimed to evaluate the impacts of procedural factors and patient characteristics on TAVI outcomes, with a focus on survival rates, cardiac mortality, and associated complications. : A retrospective, single-center study involving 224 patients who underwent TAVI at the Lithuanian University of Health Sciences from September 2021 to April 2023 was conducted. Data encompassing demographic characteristics, medical history, procedural specifics, and follow-up outcomes were analyzed. Survival and adverse events were assessed at 30 days, 6 months, and 12 months post-TAVI. The study included 224 patients. The mean age in the non-death group was 80 ± 6.17 years (range, 49-91), while that in the cardiac death group was 81.5 ± 6.14 years (range, 70-94; = 0.079). Males accounted for 37.7% of the non-death group and 50% of the cardiac death group ( = 0.304). Statistical analyses identified factors significantly associated with mortality and complications. The overall survival rate was 88.8%, with cardiac-related mortality observed in 8% of patients. Increased fluoroscopy time ( < 0.001), a higher contrast volume ( = 0.005), and less improvement in aortic valve velocity post-TAVI ( = 0.031) were significantly associated with cardiac mortality. Advanced age and a reduced left ventricular ejection fraction (<50%) were prominent predictors of adverse outcomes. Patients with non-coronary cusp calcification exhibited lower cardiac mortality ( = 0.005), while mitral valve regurgitation was linked to poorer outcomes ( = 0.015). Logistic regression analysis underscored the incremental risks posed by procedural complexities and comorbidities. : Procedural factors such as fluoroscopy duration and contrast volume, along with patient-specific attributes including age, left ventricular function, and valve calcification patterns, critically influence TAVI outcomes. These findings emphasize the need for tailored procedural strategies and patient management protocols to mitigate risks and enhance the efficacy of TAVI interventions.
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http://dx.doi.org/10.3390/medicina61010094 | DOI Listing |
Port J Card Thorac Vasc Surg
January 2025
Cardiothoracic department, Santa Cruz Hospital, Portugal.
J Clin Med
January 2025
Division of Cardiac Surgery, Spedali Civili di Brescia, University of Brescia, 25123 Brescia, Italy.
: New-onset postoperative atrial fibrillation (POAF) is the most common complication after cardiac surgery, occurring approximately in one-third of the patients. This study considered all-comer patients who underwent cardiac surgery to build a predictive model for POAF. : A total of 3467 (Center 1) consecutive patients were used as a derivation cohort to build the model.
View Article and Find Full Text PDFJ Clin Med
January 2025
National Center for Global Health, Istituto Superiore di Sanitá, 00161 Rome, Italy.
Paravalvular leak (PVL) was initially recognized as one of the most common complications after transcatheter aortic valve implantation (TAVI) and has been linked to adverse clinical outcomes, including mortality. This study aims to assess the long-term clinical effects of PVL in patients undergoing TAVI with the latest generation of transcatheter aortic valves, as part of the national observational prospective multicenter study OBSERVANT II. OBSERVANT II included all consecutive patients with severe aortic stenosis who underwent TAVI across 28 Italian centers from December 2016 to September 2018.
View Article and Find Full Text PDFJ Clin Med
January 2025
Department of Surgery, Dentistry, Pediatrics and Gynecology, Division of Cardiac Surgery, University of Verona, 37126 Verona, Italy.
Previous studies evaluated the prognostic role of hematological parameters in predicting outcome in patients with infective endocarditis (IE). However, only a few studies evaluated the role of hematological parameters in patients undergoing surgery for IE. The aim of this study was to review our 20-year experience with the treatment of native (NVE) and prosthetic (PVE) valve endocarditis and to evaluate the role of neutrophil-to-lymphocyte ratio (NLR), neutrophil-to-platelet ratio (NPR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), neutrophil-to monocyte ratio (NMR), and systemic inflammatory index (SII) on early and long-term outcomes of patients undergoing surgery for NVE and PVE.
View Article and Find Full Text PDFJ Clin Med
January 2025
Department of Cardiovascular Surgery, Ankara Yıldırım Beyazıt University Faculty of Medicine, 06010 Ankara, Türkiye.
Stuck prosthetic valves, often resulting from pannus formation or thrombus accumulation, represent a critical complication in prosthetic valve management, carrying significant risks for morbidity and mortality. This study aims to identify factors associated with stuck valve development and assess the effectiveness of interventions in restoring normal valve function. A total of 27 patients with stuck valves were analyzed, including mitral, aortic, and tricuspid valve cases.
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