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Temporal trends and clinical outcomes of transcatheter aortic valve replacement in nonagenarians

Journal of the American Heart Association Nov 13, 2019

Mentias A, Saad M, Desai MY, et al. - In order to define the contemporary results of transcatheter aortic valve replacement (TAVR) in nonagenarians, researchers undertook this inquiry in 13,544 nonagenarians (aged 90–100 years) who had TAVR and selected from Medicare claims. Nonagenarians were compared with non-nonagenarians undergoing TAVR in 2016, with respect to outcomes. In nonagenarians, a reduction in risk-adjusted 30-day mortality was reported, from 9.8% in 2012 to 4.4% in 2016, after adjusting for alterations in patients’ features, whereas a decline in mortality, from 6.4% to 3.5%, was seen in patients < 90 years. In-hospital stroke, acute kidney injury, blood transfusion, respiratory complications, heart failure, coagulopathy were all identified as important predictors of 30-day mortality in nonagenarians. Improved short-term outcomes post-TAVR were reported in nonagenarians. Among nonagenarians, the link of various procedural complications with increased 30-day mortality was also shown.
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