Valvular & structural heart disease
Urgent, Emergency, and Salvage Transcatheter Aortic Valve Implantation for Acute Decompensated Severe Aortic Stenosis: A Prospective Cohort Study
Authors' conclusion
Selected patients had high device success and low early event rates after non-elective TAVI; paired data showed sustained functional and haemodynamic improvement. These findings support timely Heart Team assessment and consideration of non-elective TAVI, when appropriate, at experienced centres; comparative benefit over alternative strategies warrants prospective study.
Study context
- Population
- Patients with acute decompensated severe aortic stenosis undergoing urgent, emergency, or salvage transcatheter aortic valve implantation (TAVI), 2022–2025
- Participants
- 53 patients
- Exposure
- Urgent vs emergency vs salvage
- Urgentn = 36
- Emergencyn = 14
- Salvagen = 3
- Outcome
- All-cause mortality
- Follow-up
- 12 months
Methodological detailsone centre
- One centre
Main finding
As reported in the abstract
Urgent
2 of 36
events
Emergency
1 of 14
events
Salvage
0 of 3
events
- Overall 12-month mortality
- 3/53
- Kaplan-Meier 12-month survival
- 94.3% (95% confidence interval 83.5-98.1%)
Observational data: associations, not effects.
Secondary outcomes
Device success
- Device success
- 52/53 (98.1%)
Paired functional and echocardiographic recovery (NYHA class, KCCQ-12, LVEF, transvalvular gradients) · 30 days and 12 months
- Improved New York Heart Association class, Kansas City Cardiomyopathy Questionnaire-12, left ventricular ejection fraction, and transvalvular gradients
- all P<0.001
- Paired analyses
Safety
| Outcome | Urgent | Emergency | Salvage |
|---|---|---|---|
| Thirty-day mortality · 30 days | 1/36 events | 0/14 events | 0/3 events |
New atrioventricular block · postoperative day 2
- New atrioventricular block
- 2/53
30-day safety events
- Haemofiltration or renal replacement therapy
- 1/53
- Permanent pacemaker implantation
- 0/53
12-month events
- Cardiovascular mortality
- 2/53
- Heart-failure readmission
- 4/53
- Stroke
- 1/53
- Separate Valve Academic Research Consortium-3 type 2 bleeding event
- 1/53
- Permanent pacemaker implantation
- 0/53
Original publication
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