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Feasibility and clinical outcomes in nonagenarians undergoing transcatheter aortic valve replacement with the LOTUSTM valve

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Journal of Geriatric Cardiology 2016年第7期13卷 636-638页

作者： Satish Ramkumar hashrul n rashid Sarah Zaman Liam McCormick Robert Gooley Damon Jackson Ian T Meredith MonashHEART Monash Health Melbourne Victoria Australia Monash Cardiovascular Research Centre Monash University Melbourne Victoria Australia

Surgical aortic valve replacement （AVR） is associated with very high peri-operative risk in the nonagenarian populationflI Patients with severe aortic stenosis treated conservatively have high rates of mortality with poor quality of life and loss of independence. Transcatheter aortic valve replacement （TAVR） has been validated in the high risk elderly population as a viable alternative to surgery with comparable outcomes.

关键词： Aortic valve replacement nonagenarian patients Transcatheter aortic valve replacement

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Bleeding outcomes after non-emergency percutaneous coronary intervention in the very elderly

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Journal of Geriatric Cardiology 2017年第10期14卷 624-631页

作者： Vimalraj Bogana Shanmugam Dennis T Wong hashrul rashid James D Cameron Yuvaraj Malaiapan Peter J Psaltis Monash Cardiovascular Research Centre Clayton Campus of Monash University Victoria Australia South Australian Health and Medical Research Institute Adelaide Australia

Background Octogenarians constitute an increasing proportion of patients presenting for non-emergency percutaneous coronary intervention （PCI）. Methods This study evaluated the in-hospital procedural characteristics and outcomes, including the bleeding events of 293 octogenarians presenting between January 2010 and December 2012 for non-emergency PCI to a single large volume tertiary care Aus- tralian center. Comparisons were made with 293 consecutive patients aged less than or equal to 60 years, whose lesions were matched with the octogenarians. Results non-ST elevation myocardial infarction was the most frequent indication for non-emergency PCI in octoge- narians. Compared to the younger cohort, they had a higher prevalence of co-morbidities and more complex coronary disease, comprising more type C and calcified lesions. Peri-procedural use of low molecular weight heparin （LMWH; 1.0% vs. 5.8%; P 〈 0.001） and glycopro- tein IIb/IIIa inhibitors （2.1% vs. 9.6%; P 〈 0.001） was lower, while femoral arterial access was used more commonly than in younger patients （80.9% vs. 67.6%; P 〈 0.001）. Overall, there was a non-significant trend towards higher incidence of all bleeding events in the elderly （9.2% vs. 5.8%; P = 0.12）. There was no significant difference in access site or non-access site bleeding and major or minor bleeding between the two cohorts. Sub-analysis did not reveal any significant influence on bleeding rates by the use of LMWH, glycoprotein IIb/IIIa inhibitors or femoral arterial access. In addition, there were no significant differences in the rates of in-hospital mortality, stroke or acute stent thrombosis between the two groups. Conclusions In this single center study, we did not observe significant increases in adverse in-hospital outcomes including the incidence of bleeding in octogenarians undergoing non-emergency PCI.

关键词： Bleeding Coronary artery disease Octogenarians Percutaneous coronary intervention

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