Transcatheter Valve Implantation Benefits Even Very Elderly
No significant differences in 30-day, one-year mortality for those 85-89, ≥90 versus 80-84 years
FRIDAY, Jan. 10, 2014 (HealthDay News) -- Transcatheter aortic valve implantation is associated with acceptable clinical outcomes, even among very elderly patients, according to a study published in the January issue of the Annals of Thoracic Surgery.
Masanori Yamamoto, M.D., from the Centre Hospitalier Universitaire Henri Mondor in Créteil, France, and colleagues examined age-specific differences in clinical outcomes for 867 patients aged 80 to 84 years; 1,064 patients aged 85 to 89 years; and 349 patients aged ≥90 years. All patients were enrolled in the French national transcatheter aortic valve implantation registry.
The researchers observed no differences among groups in the rates of procedural success, complications, or length of hospitalization. There were no significant differences between the groups in cumulative 30-day mortality (10.3, 9.5, and 11.2 percent, respectively, for those aged 80 to 84 years, 85 to 89 years, and ≥90 years; P = 0.53). No significant differences were seen in cumulative one-year mortalities, although the mortality rate was higher in patients aged 85 to 89 and ≥90 years compared with those aged 80 to 84 years (19.8 versus 26.1 and 27.7 percent, respectively; P = 0.16). Patient age (85 to 89 and ≥90 versus 80 to 84 years) was not associated with increased 30-day mortality risk (hazard ratios, 0.92 [P = 0.38] and 1.26 [P = 0.28], respectively) or with one-year mortality risk (hazard ratios, 1.16 [P = 0.25] and 1.36 [P = 0.073], respectively), after adjustment for baseline characteristics and potential confounders.
"Transcatheter aortic valve implantation may be a good therapeutic option even in very elderly patients (85 to 89 years and ≥90 years)," the authors write.
Several authors disclosed financial ties to the medical device industry.
Abstract (http://www.annalsthoracicsurgery.org/article/S0003-4975(13)01713-X/abstract )Full Text (http://annalsthoracicsurgery.org/article/S0003-4975(13)01713-X/fulltext )