Predictors of mortality and outcomes of therapy in low-flow severe aortic stenosis: a Placement of Aortic Transcatheter Valves (PARTNER) trial analysis.
Publication/Presentation Date
6-11-2013
Abstract
BACKGROUND: The prognosis and treatment of patients with low-flow (LF) severe aortic stenosis are controversial.
METHODS AND RESULTS: The Placement of Aortic Transcatheter Valves (PARTNER) trial randomized patients with severe aortic stenosis to medical management versus transcatheter aortic valve replacement (TAVR; inoperable cohort) and surgical aortic valve replacement versus TAVR (high-risk cohort). Among 971 patients with evaluable echocardiograms (92%), LF (stroke volume index ≤35 mL/m(2)) was observed in 530 (55%); LF and low ejection fraction (
CONCLUSIONS: LF is common in severe aortic stenosis and independently predicts mortality. Survival is improved with TAVR compared with medical management and similar with TAVR and surgical aortic valve replacement. A measure of flow (stroke volume index) should be included in the evaluation and therapeutic decision making of patients with severe aortic stenosis.
CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrial.gov. Unique identifier: NCT0053089.4.
Volume
127
Issue
23
First Page
2316
Last Page
2326
ISSN
1524-4539
Published In/Presented At
Herrmann, H. C., Pibarot, P., Hueter, I., Gertz, Z. M., Stewart, W. J., Kapadia, S., Tuzcu, E. M., Babaliaros, V., Thourani, V., Szeto, W. Y., Bavaria, J. E., Kodali, S., Hahn, R. T., Williams, M., Miller, D. C., Douglas, P. S., & Leon, M. B. (2013). Predictors of mortality and outcomes of therapy in low-flow severe aortic stenosis: a Placement of Aortic Transcatheter Valves (PARTNER) trial analysis. Circulation, 127(23), 2316–2326. https://doi.org/10.1161/CIRCULATIONAHA.112.001290
Disciplines
Medicine and Health Sciences
PubMedID
23661722
Department(s)
Department of Surgery
Document Type
Article