@entity453 and Symptomatic Severe XXXX : Clinical Outcomes after Transcatheter Aortic Valve Implantation.

@entity1 @entity453 @entity472 @entity204
INTRODUCTION: The impact of @entity453 ( @entity453 ) on outcomes after transcatheter aortic valve implantation (TAVI) has not been clarified. Furthermore, less is known about the indication and strategy of revascularization in these high risk @entity1 . AIMS: This study sought to determine the prevalence and prognostic impact of @entity453 in @entity1 undergoing TAVI, and to assess the safety and feasibility of percutaneous coronary intervention (PCI) before TAVI. METHODS: @entity1 with severe @entity472 ( @entity472 ) undergoing TAVI were included into a prospective single center registry from 2007 to 2012. Clinical outcomes were compared between @entity1 with and without @entity453 . In some @entity1 with @entity453 , it was decided to perform elective PCI before TAVI after decision by the Heart team. The primary endpoints were 30-day and 2-year all-cause mortality. RESULTS: A total of 91 consecutive @entity1 with mean age of 79        9   years (52% @entity1 ) underwent TAVI with a median follow-up duration of 16   months (interquartile range of 27.6   months). @entity453 was present on 46 @entity1 (51%). At 30-day, the incidences of @entity204 were similar between @entity453 and non- @entity453 @entity1 (9 and 5%, p   =   0.44), but at 2   years were 50% in @entity453 @entity1 and 24% in non- @entity453 @entity1 [crude hazard ratio with @entity453 , 2.2; 95% confidence interval (CI), 1.1-4.6; p   =   0.04]. Adjusting for age, gender, left ventricular ejection fraction, and glomerular filtration rate, the hazard of @entity204 was 2.6-fold higher in @entity1 with @entity453 (95% CI, 1.1-6.0; p   =   0.03). Elective PCI before TAVI was performed in 13 @entity1 (28% of @entity453 @entity1 ). There were no more adverse events in @entity1 who underwent TAVI   +   PCI when compared with those who underwent isolated TAVI. CONCLUSION: In severe symptomatic @entity472 who underwent TAVI, @entity453 is frequent and adversely impacts long-term outcomes, but not procedure outcomes. In selected @entity1 , PCI before TAVI appears to be feasible and safe.
