# TAVI bij aortaklepstenose met ATTR-amyloïdose: hogere late sterfte en HF-heropnames

*geplaatst 2026-09-11 · Algemeen · European journal of heart failure · doi 10.1093/ejhf/xuag285 · https://hartvaat.nl/2026/09/03/tavi-bij-aortaklepstenose-met-attr-amyloidose-hogere-late-sterfte-en-hf-heropnam/*

Een systematische review van elf observationele studies (ruim 644.000 patiënten met geïsoleerde aortaklepstenose en 1.637 met bijkomende ATTR-cardiomyopathie) toont aan dat patiënten met ATTR-amyloïdose na TAVI een hoger risico lopen op acute nierinsufficiëntie, permanente pacemaker-implantatie, hartfalenheropnames en late all-cause sterfte. De 30-daagse mortaliteit en incidenties van beroerte of bloedingen zijn vergelijkbaar. Deze bevindingen onderstrepen dat ATTR-amyloïdose geen contra-indicatie voor TAVI is, maar wel risicostratificatie, peri-proceduraal beleid en intensievere follow-up rechtvaardigt.

## English: Early and Late TAVI Outcomes in Aortic Stenosis with Transthyretin Cardiac Amyloidosis: A Systematic Review.

A systematic review of 11 observational studies (644,107 patients with isolated aortic stenosis and 1,637 with concomitant ATTR cardiac amyloidosis) demonstrates that ATTR-CA patients undergoing TAVI face higher rates of acute kidney injury, permanent pacemaker implantation, heart failure readmissions, and late all-cause mortality compared to those with isolated stenosis. Thirty-day mortality, stroke, and major bleeding rates remain similar between groups. These findings indicate that ATTR-CA should not preclude TAVI but warrants tailored risk stratification, peri-procedural planning, and structured post-procedural follow-up.

## Abstract (original, from the publication)

Concomitant transthyretin cardiac amyloidosis (ATTR-CA) is increasingly recognized among elderly patients with severe aortic stenosis (AS) referred to transcatheter aortic valve implantation (TAVI), yet its impact on early and late outcomes remains incompletely defined. We conducted a systematic review of studies comparing TAVI outcomes in patients with isolated AS and those with AS+ATTR-CA. Eleven observational studies were included, comprising 644,107 patients with isolated AS and 1,637 with AS+ATTR-CA. AS+ATTR-CA patients were older, more frequently male, and showed more atrial fibrillation, mildly reduced left ventricular ejection fraction, and markedly elevated cardiac biomarkers. Thirty-day mortality was low and similar between groups, with no consistent differences in stroke or major bleeding, whereas acute kidney injury and permanent pacemaker implantation were more frequent in AS+ATTR-CA. During follow-up, AS+ATTR-CA patients experienced higher heart failure readmissions and late all-cause mortality. ATTR-CA should not preclude TAVI but should inform risk stratification, peri-procedural management, and post-TAVI follow-up.

Auteurs: Martina Giusti, Pietro Giorgio Malvindi, Martina Benedetti, Fabio Vagnarelli, Carla Lofiego, Irene Capodaglio, Francesca Patani, Marco Marini, Gianfranco Sinagra, Christian Nitsche, Aldostefano Porcari, Marco Di Eusanio

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Bron: European journal of heart failure, https://doi.org/10.1093/ejhf/xuag285. Bijgewerkt 2026-09-04T01:23:33Z. 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.