Long-Term Health Benefit of Transcatheter Aortic Valve Replacement in Patients With Chronic Lung Disease

Juan A. Crestanello, Jeffrey J. Popma, David H. Adams, G. Michael Deeb, Mubashir Mumtaz, Barry George, Jian Huang, Michael J. Reardon

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Objectives This study sought to characterize the long-term effect of chronic lung disease (CLD) on mortality, clinical outcomes, quality of life, and health benefits after transcatheter aortic valve replacement (TAVR) with a self-expanding bioprosthesis. Background The long-term effect of CLD after TAVR is unknown. Methods Prevalence and severity of CLD was determined at baseline in high- and extreme-risk patients with aortic stenosis from the CoreValve US Pivotal Trial. Clinical outcomes and health status were assessed using the Kansas City Cardiomyopathy Questionnaire overall summary score (KCCQ-OS). A favorable health benefit was defined as alive with a KCCQ-OS ≥60 and stability (<10-point decrease) or improvement in the KCCQ-OS from baseline. Results CLD was present in 55% (20% mild, 13% moderate, 22% severe) of the 1,030 patients studied. All-cause mortality was higher in patients with moderate and severe CLD at 1 year (19.6% mild, 28.1% moderate, 26.9% severe CLD vs. 19.2% non-CLD; p = 0.030) and 3 years (44.8% mild, 53.0% moderate, 51.9% severe vs. 37.7% non-CLD; p < 0.001). New York Heart Association functional class improved in more than 80% of patients with CLD at 1 and 3 years. All patients had a nearly 20-point improvement in KCCQ-OS at 1 and 3 years. However, only 43.3% of patients with CLD had a favorable health benefit at 1 year and 22.5% at 3 years. Conclusions Moderate and severe CLD increases 1- and 3-year mortality after TAVR. Although functional status and quality of life were improved in CLD at 1 and 3 years after TAVR, a favorable health benefit was only achieved in selected patients. (Safety and Efficacy Study of the Medtronic CoreValve System in the Treatment of Symptomatic Severe Aortic Stenosis in High Risk and Very High Risk Subjects Who Need Aortic Valve Replacement; NCT01240902)

Original languageEnglish (US)
Pages (from-to)2283-2293
Number of pages11
JournalJACC: Cardiovascular Interventions
Volume10
Issue number22
DOIs
StatePublished - Nov 27 2017

Keywords

  • Kansas City Cardiomyopathy Questionnaire
  • chronic lung disease
  • chronic obstructive pulmonary disease
  • clinical outcomes
  • quality of life
  • transcatheter aortic valve replacement

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint

Dive into the research topics of 'Long-Term Health Benefit of Transcatheter Aortic Valve Replacement in Patients With Chronic Lung Disease'. Together they form a unique fingerprint.

Cite this