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Transcatheter Aortic Valve Implantation in Patients with Connective Tissue Disease

Hüseyin Ayhan1, Bilge Duran Karaduman1, Telat Keleş2

  • 1Atılım University, Faculty of Medicine, Department of Cardiology, Medicana International Ankara Hospital.

Acta Cardiologica Sinica
|January 25, 2021
PubMed

Insights

Transcatheter aortic valve implantation (TAVI) is feasible and safe for patients with connective tissue disease (CTD) and severe aortic stenosis. While TAVI in CTD patients showed similar mid-term outcomes, it required more pacemaker implants but had fewer major complications.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Rheumatology

Background:

  • Treatment consensus for severe aortic stenosis (AS) in connective tissue disease (CTD) patients is lacking.
  • Transcatheter aortic valve implantation (TAVI) is an emerging option for AS, but its use in CTD patients requires further evaluation.

Purpose of the Study:

  • To assess the feasibility and safety of TAVI in patients diagnosed with connective tissue disease (CTD).

Main Methods:

  • Retrospective analysis of 550 severe AS patients undergoing TAVI (2011-2019).
  • Comparison of outcomes between 14 CTD patients and the remaining 536 non-CTD patients.
  • Follow-up at 30 days, 6 months, and 1 year post-procedure.

Main Results:

  • CTD patients (2.5%) were predominantly female (85.7%) and had rheumatoid arthritis (n=10).
  • No significant differences in mean age, discharge time, or in-hospital mortality between CTD and non-CTD groups.
  • CTD group had significantly higher permanent pacemaker implantation rates (p=0.008) but numerically lower major complications (e.g., no acute kidney injury, stroke, bleeding, or effusion).

Conclusions:

  • TAVI demonstrates similar mid-term safety and efficacy in patients with and without CTD.
  • The CTD cohort experienced a higher need for permanent pacemaker implantation.
  • TAVI offers a viable treatment option for severe AS in CTD patients, with a potentially lower rate of major complications.
Abstract

Keywords:
Aortic stenosisConnective tissue diseaseRheumatoid arthritisTAVI

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