According to a new study, the occurrence of in-hospital stroke after transcatheter aortic valve implantation (TAVI) is associated with a significant increase in early and late mortality. The research published in Catheterization and Cardiovascular Interventions also identified the factors independently associated with in-hospital stroke after TAVI.
Researchers conducted an observational cohort analysis of the multicentre UK TAVI registry. A total of 8,652 TAVI procedures performed between 2007 and 2015 across 33 centres in the UK were included in the analysis.
A total of 205 in-hospital strokes were reported, corresponding to an overall stoke incidence of 2.4 per cent. Implantation of balloon-expandable valves versus self-expandable valves was associated with significantly fewer pre-discharge strokes (2.08% vs. 2.90%; P=.020). In-hospital stroke after TAVI was associated with a significantly increased 30-day (OR, 5.22; P<.001) and one-year (OR, 3.21; P<.001) mortality. In a multivariable analysis, independent risk factors for in-hospital stroke were cerebrovascular disease (OR, 1.51; P=.034), advanced age at the time of the procedure (OR, 1.02; P=.051), bailout coronary stenting (OR, 5.94; P=.008) and earlier year of procedure (OR, 0.93; P=.043).
The authors commented: "Identification of such indices represents an opportunity to mitigate risk and upscale quality improvement with respect to procedural eligibility, enhancing informed patient consent, and optimization of preoperative planning. Those identified at higher risk may also benefit from a more individualized antithrombotic strategy approach."
