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Updated: Jan 6, 2026
Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
Published on: May 21, 2017
Prediction of One-Year Mortality Based upon A New Staged Mortality Risk Model in Patients with Aortic Stenosis
Verena Veulemans1, Amin Polzin2, Oliver Maier3
1Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University, Medical Faculty, Moorenstr. 5, 40225 Düsseldorf, Germany. Verena.Veulemanns@med.uni-duesseldorf.de.
Background:
In-depth knowledge about potential predictors of mortality in transcatheter aortic valve replacement (TAVR) is still warranted. Currently used risk stratification models for TAVR often fail to reach a holistic approach. We, therefore, aimed to create a new staged risk model for 1-year mortality including several new categories including (a) AS-entities (b) cardiopulmonary hemodynamics (c) comorbidities, and (d) different access routes.
Methods:
737 transfemoral (TF) TAVR (84.3%) and 137 transapical (TA) TAVR (15.7%) patients were included. Predictors of 1-year mortality were assessed according to the aforementioned categories.
Results:
Over-all 1-year mortality (n = 100, 11.4%) was significantly higher in the TA TAVR group (TF vs. TA TAVR: 10.0% vs. 18.9 %; p = 0.0050*). By multivariate cox-regression analysis, a three-staged model was created in patients with fulfilled categories (TF TAVR: n = 655, 88,9%; TA TAVR: n = 117, 85.4%). Patients in "stage 2" showed 1.7-fold (HR 1.67; CI 1.07-2.60; p = 0.024*) and patients in "stage 3" 3.5-fold (HR 3.45; CI 1.97-6.05; p < 0.0001*) enhanced risk to die within 1 year. Mortality increased with every stage and reached the highest rates of 42.5% in "stage 3" (plogrank < 0.0001*), even when old- and new-generation devices (plogrank = n.s) were sub-specified.
Conclusions:
This new staged mortality risk model had incremental value for prediction of 1-year mortality after TAVR independently from the TAVR-era.
