The incidence, predictive factors and prognosis of acute pulmonary complications after transcatheter aortic valve implantation

Tetsuro Shimura, Masanori Yamamoto, Ai Kagase, Atsuko Kodama, Seiji Kano, Yutaka Koyama, Norio Tada, Kensuke Takagi, Motoharu Araki, Futoshi Yamanaka, Shinichi Shirai, Yusuke Watanabe, Kentaro Hayashida

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

OBJECTIVES: Although acute pulmonary complications (APCs), such as the exacerbation of pulmonary disease (PD) or a newly developed pulmonary event, are thought to be catastrophic after invasive therapy, little is known about the occurrence of APCs after transcatheter aortic valve implantation (TAVI). This study aims to clarify the incidence, predictive factors and impact of APCs on prognosis after TAVI. METHODS: We identified 749 patients who underwent TAVI, using data from the Optimized CathEter vAlvular iNtervention (OCEANTAVI) Japanese multicentre registry. APCs were defined as exacerbation of a comorbidity or newly developed PD during hospitalization. Patients were divided into 2 groups: An APC group (1.5%, 11/749) and a non-APC group (98.5%, 738/749). Clinical and prognostic outcomes were compared, and predictive factors for APCs were assessed. RESULTS: Procedure-related death did not differ between the groups (0.4% vs 0.0%, P = 1.00), although 30-day mortality was significantly higher in the APC group than in the non-APC group (27.3% vs 1.6%, P = 0.001) and the difference in cumulative 1-year mortality increased further (72.7% vs 8.6%, log-rank test: P < 0.001). In particular, concomitant PD and transapical (TA) approach were identified as predictors of APCs after TAVI [univariable odds ratio (uOR) = 24.2, 95% confidence interval (CI) = 3.08-189.9, P = 0.002; uOR = 3.69, 95% CI = 1.11-12.3, P = 0.033, respectively]. CONCLUSIONS: Although rare, the occurrence of APCs after TAVI was associated with extremely poor prognosis. Patients undergoing TAVI with concomitant PD and/or TA require careful consideration to avoid the risk of APCs.

Original languageEnglish
Pages (from-to)191-197
Number of pages7
JournalInteractive Cardiovascular and Thoracic Surgery
Volume25
Issue number2
DOIs
Publication statusPublished - 2017 Aug 1

    Fingerprint

Keywords

  • Acute pulmonary complication
  • Ocean
  • Pulmonary disease
  • Transcatheter aortic valve implantation

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Shimura, T., Yamamoto, M., Kagase, A., Kodama, A., Kano, S., Koyama, Y., Tada, N., Takagi, K., Araki, M., Yamanaka, F., Shirai, S., Watanabe, Y., & Hayashida, K. (2017). The incidence, predictive factors and prognosis of acute pulmonary complications after transcatheter aortic valve implantation. Interactive Cardiovascular and Thoracic Surgery, 25(2), 191-197. https://doi.org/10.1093/icvts/ivx075