{"id":"04bfe2b30f23","type":"article","url":"https://hartvaat.nl/2026/05/21/1-op-10-patienten-heroptname-binnen-30-dagen-na-tavi-sterfterisico-na-1-jaar-ver/","title":"1 op 10 patiënten heroptname binnen 30 dagen na TAVI — sterfterisico na 1 jaar verdrievoudigd","title_en":"","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":["acuut-hartfalen"],"journal":"Open heart","doi":"10.1136/openhrt-2026-004059","source_url":"https://doi.org/10.1136/openhrt-2026-004059","authors":["Polyxeni Alexiou","Federico Moccetti","Indra Bat-Ochir","Lorena Niederberger","Stephanie Brunner","Urs Jeker","Matthias Paul","Florim Cuculi","Mathias Wolfrum","Stefan Toggweiler"],"significance":7,"published":"2026-06-09","source_date":"2026-05-21","image":"https://hartvaat.nl/global/img/3b29446e6e22.webp","kennis":["https://hartvaat.nl/kennis/kleplijden/esc-richtlijn-kleplijden-2021/","https://hartvaat.nl/kennis/farmacologie/betablokkers-cardiale-indicaties/"],"congress":"","summary_en":"Retrospective analysis of 1,347 consecutive TAVI patients (43.8% women, mean age 81 years; 2012-2025). 9.7% (n=131) were readmitted within 30 days, most commonly for infection (22.9%), heart failure (19.8%) and bradycardia (9.9%). Independent predictors of infection readmission: chronic HF (OR 2.60), COPD (OR 3.18) and contrast volume (OR 1.25 per 25 mL). HF readmission was predicted by chronic HF (OR 3.82), paravalvular leak ≥mild (OR 5.05) and reduced post-procedure LVEF (OR 3.85). Discharge conduction abnormalities predicted bradycardia readmission (OR 4.65). Early discharge (≤2 days) did not increase readmission risk. After adjustment, 1-year mortality was three times higher with early readmission (HR 3.03; 95% CI 1.90-4.86). Modifiable risk factors include contrast volume, paravalvular leak, and discharge conduction abnormalities.","created":"2026-07-03T10:33:01Z","updated":"2026-07-03T18:39:35Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Retrospectieve analyse van 1.347 consecutieve TAVI-patiënten (43,8% vrouwen, gemiddelde leeftijd 81 jaar; 2012-2025). 9,7% (n=131) werd binnen 30 dagen heropgenomen, voornamelijk wegens infectie (22,9%), hartfalen (19,8%) en bradycardie (9,9%). Onafhankelijke voorspellers van heropname voor infectie waren chronisch hartfalen (OR 2,60), COPD (OR 3,18) en contrastvolume (OR 1,25 per 25 mL). HF-heropname werd voorspeld door chronisch hartfalen (OR 3,82), paravalvulaire lekkage ≥mild (OR 5,05) en verlaagde post-procedurele LVEF (OR 3,85). Geleidingsstoornissen bij ontslag voorspelden bradycardie-heropname (OR 4,65). Vroeg ontslag (≤2 dagen) vergrootte het heropname-risico níet. De 1-jaars sterfte was na correctie drie keer hoger bij vroege heropname (HR 3,03; 95%-BI 1,90-4,86). Beïnvloedbare risicofactoren zijn contrastvolume, paravalvulaire lekkage en geleidingsstoornissen bij ontslag.","abstract_original":"BACKGROUND: Early rehospitalisation after transcatheter aortic valve implantation (TAVI) is frequently required but data regarding its prevalence, aetiology, predictors and prognostic relevance are limited. METHODS: We retrospectively analysed consecutive patients undergoing TAVI between August 2012 and October 2025. Early rehospitalisation was defined as any admission within 30 days from the index hospitalisation. Data regarding rehospitalisation causes, predictors, outcomes and impact on mortality were collected. Associations were evaluated using univariable and multivariable logistic and Cox regression models and Kaplan-Meier curve analyses. RESULTS: A total of 1347 patients (43.8% women, mean age 81±6 years) were included. Early rehospitalisation was required in 131 (9.7%), most frequently due to infection (22.9%), heart failure (HF 19.8%) and bradycardia (9.9%). Independent predictors of rehospitalisation for infection were chronic HF (OR 2.60, 95% CI 1.02 to 6.59; p=0.045), chronic obstructive pulmonary disease (OR 3.18, 95% CI 1.27 to 7.96; p=0.013) and contrast dye volume (OR 1.25 per 25 mL increase, 95% CI 1.09 to 1.44; p=0.002). Rehospitalisation for decompensated HF was significantly associated with chronic HF (OR 3.82, 95% CI 1.24 to 11.81; p=0.020), paravalvular leak ≥mild (OR 5.05, 95% CI 1.50 to 16.98; p=0.009) and reduced postprocedural ejection fraction (OR 3.85, 95% CI 1.20 to 12.50; p=0.022). Conduction abnormalities at discharge predicted rehospitalisation for bradycardia requiring pacemaker implantation (OR 4.65, 95% CI 1.39 to 15.57; p=0.013). Early (≤2 days) discharge was not associated with an increased risk of rehospitalisation (27.7% vs 20.3%, p=0.073). 1-year all-cause mortality was higher for the early rehospitalisation group after multivariable adjustment (HR 3.03, 95% CI 1.90 to 4.86; p<0.001). CONCLUSIONS: Nearly one-tenth of patients were readmitted after index hospitalisation. The most prevalent causes were infection, HF and bradycardia. Modifiable risk factors were contrast dye volume, ≥mild paravalvular leaks and discharge conduction abnormalities. Early discharge did not predict rehospitalisation. Mortality risk at 1 year was three times higher in patients requiring early rehospitalisation."}