Impact of left ventricular function and transaortic gradient on outcomes from transcatheter XXXX : data from the UK TAVI Registry.

@entity1 @entity886 @entity1351
AIMS: Aortic valve surgery in the presence of reduced ejection fraction (EF) or low transaortic gradient is associated with adverse outcome. Low gradient (LG) may be associated with reduced EF, known as low EF-low gradient (LEF-LG), or "paradoxically" low with normal EF ( @entity1351 ). Our aim was to investigate the impact of EF and transaortic gradient on outcome following transcatheter @entity886 (TAVI). METHODS AND RESULTS: We retrospectively analysed the UK TAVI Registry from 2007 to 2011 (n=2,535 consecutive @entity1 , mean age 81.3  7.5, logistic EuroSCORE 21.8  14). Thirty-day mortality was 7.8%, low EF (<50%) was present in 39%, low gradient (<64 mmHg) was present in 27%, LEF-LG in 15% and @entity1351 in 12% of @entity1 , respectively. LEF-LG @entity1 had the highest risk profile vs. the other groups (EuroSCORE 30  16 vs. 20  12, p<0.001). Neither EF nor gradient impacted on procedural outcome or 30-day mortality. Mortality at two years was significantly higher in LEF-LG @entity1 (34.7%), whereas, in @entity1 with low EF/high gradient (27.8%) or normal EF/low gradient (23%), mortality was not significantly different from that of normal EF/high gradient (23%) @entity1 . LEF-LG independently predicted reduced survival, HR 1.7 (1.4-2.1). CONCLUSIONS: Neither low EF nor low gradient affected procedural success or 30-day mortality. Long-term survival was reduced in LEF-LG @entity1 but not in those with low EF and high gradient or @entity1351 with normal EF.
