Research
Print page Print page
Switch language
Rigshospitalet - a part of Copenhagen University Hospital
Published

Transcatheter Aortic Valve Replacement in Oncology Patients With Severe Aortic Stenosis

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Patient-Specific Implantation Technique to Obtain Neo-Commissural Alignment With Self-Expanding Transcatheter Aortic Valves

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Technical Considerations for Transcatheter Aortic Valve Replacement With the Navitor Transcatheter Heart Valve

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Infective Endocarditis Following Transcatheter Aortic Valve Replacement and Cardiac Implantable Electronic Device

    Research output: Contribution to journalLetterResearchpeer-review

  4. Transcatheter Treatment of Residual Significant Mitral Regurgitation Following TAVR: A Multicenter Registry

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Redo-TAVR: What About the Coronary Arteries?

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Temporal trends in utilization of transcatheter aortic valve replacement and patient characteristics: a nationwide study

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Incidence of Infective Endocarditis Among Patients With Tetralogy of Fallot

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Patient-Specific Implantation Technique to Obtain Neo-Commissural Alignment With Self-Expanding Transcatheter Aortic Valves

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Technical Considerations for Transcatheter Aortic Valve Replacement With the Navitor Transcatheter Heart Valve

    Research output: Contribution to journalJournal articleResearchpeer-review

  • Uri Landes
  • Zaza Iakobishvili
  • Daniella Vronsky
  • Oren Zusman
  • Alon Barsheshet
  • Ronen Jaffe
  • Ayman Jubran
  • Sung-Han Yoon
  • Raj R Makkar
  • Maurizio Taramasso
  • Marco Russo
  • Francesco Maisano
  • Jan-Malte Sinning
  • Jasmin Shamekhi
  • Luigi Biasco
  • Giovanni Pedrazzini
  • Marco Moccetti
  • Azeem Latib
  • Matteo Pagnesi
  • Antonio Colombo
  • Corrado Tamburino
  • Paolo D' Arrigo
  • Stephan Windecker
  • Thomas Pilgrim
  • Didier Tchetche
  • Chiara De Biase
  • Mayra Guerrero
  • Omer Iftikhar
  • Johan Bosmans
  • Edo Bedzra
  • Danny Dvir
  • Darren Mylotte
  • Horst Sievert
  • Yusuke Watanabe
  • Lars Søndergaard
  • Hanna Dagnegård
  • Pablo Codner
  • Susheel Kodali
  • Martin Leon
  • Ran Kornowski
View graph of relations

OBJECTIVES: The authors sought to collect data on contemporary practice and outcome of transcatheter aortic valve replacement (TAVR) in oncology patients with severe aortic stenosis (AS).

BACKGROUND: Oncology patients with severe AS are often denied valve replacement. TAVR may be an emerging treatment option.

METHODS: A worldwide registry was designed to collect data on patients who undergo TAVR while having active malignancy. Data from 222 cancer patients from 18 TAVR centers were compared versus 2,522 "no-cancer" patients from 5 participating centers. Propensity-score matching was performed to further adjust for bias.

RESULTS: Cancer patients' age was 78.8 ± 7.5 years, STS score 4.9 ± 3.4%, 62% men. Most frequent cancers were gastrointestinal (22%), prostate (16%), breast (15%), hematologic (15%), and lung (11%). At the time of TAVR, 40% had stage 4 cancer. Periprocedural complications were comparable between the groups. Although 30-day mortality was similar, 1-year mortality was higher in cancer patients (15% vs. 9%; p < 0.001); one-half of the deaths were due to neoplasm. Among patients who survived 1 year after the TAVR, one-third were in remission/cured from cancer. Progressive malignancy (stage III to IV) was a strong mortality predictor (hazard ratio: 2.37; 95% confidence interval: 1.74 to 3.23; p < 0.001), whereas stage I to II cancer was not associated with higher mortality compared with no-cancer patients.

CONCLUSIONS: TAVR in cancer patients is associated with similar short-term but worse long-term prognosis compared with patients without cancer. Among this cohort, mortality is largely driven by cancer, and progressive malignancy is a strong mortality predictor. Importantly, 85% of the patients were alive at 1 year, one-third were in remission/cured from cancer. (Outcomes of Transcatheter Aortic Valve Implantation in Oncology Patients With Severe Aortic Stenosis [TOP-AS]; NCT03181997).

Original languageEnglish
JournalJACC: Cardiovascular Interventions
Volume12
Issue number1
Pages (from-to)78-86
Number of pages9
ISSN1936-8798
DOIs
Publication statusPublished - 14 Jan 2019

    Research areas

  • Aged, Aged, 80 and over, Aortic Valve/diagnostic imaging, Aortic Valve Stenosis/diagnostic imaging, Cause of Death, Disease Progression, Female, Humans, Male, Neoplasm Staging, Neoplasms/mortality, Recovery of Function, Registries, Remission Induction, Risk Assessment, Risk Factors, Severity of Illness Index, Time Factors, Transcatheter Aortic Valve Replacement/adverse effects, Treatment Outcome

ID: 59141320