TAVI in Cancer Patients How Often and When is it Truly Indicated

Dan Gilon Cardiology, Hadassah Medical Center, Jerusalem, Ein kerem, Israel Ivelin Koev Cardiology, Hadassah Medical Center, Jerusalem, Ein kerem, Israel Gidon Pearlman Cardiology, Hadassah Medical Center, Jerusalem, Ein kerem, Israel David Planner Cardiology, Hadassah Medical Center, Jerusalem, Ein kerem, Israel Mahsati Ibrahimli Cardiology, Hadassah Medical Center, Jerusalem, Ein kerem, Israel Naseem Shadafny Cardiology, Hadassah Medical Center, Jerusalem, Ein kerem, Israel Mony Shuvy Cardiology, Hadassah Medical Center, Jerusalem, Ein kerem, Israel Chaim Lotan Cardiology, Hadassah Medical Center, Jerusalem, Ein kerem, Israel Haim Danenberg Cardiology, Hadassah Medical Center, Jerusalem, Ein kerem, Israel

Background: Transcathter Aortic Valve Implantation (TAVI) has become common practice in the treatment of patients with aortic stenosis. While initially reserved for patients declined of surgery due to extreme or high risk, TAVI is currently expanding to patients at lower surgical risk.

Methods: In a single center cohort of consecutive TAVI patients we analyzed patients that were diagnosed with cancer of any type.

Results: Out of a total of 390 patients in which TAVI was performed 52 (13.3%) had a diagnosis of cancer. There were 30 women and 22 men. The malignancies included breast cancer (11), prostate cancer (10), colon cancer (5), hematologic malignancies (4), renal tumors (4), bladder (3), cervix and ovary (2), malignant melanoma and other skin malignancies (5) and 7 uncertain.

Radiation was included as treatment in 5 of the 52 patients.

Conclusions: TAVI is often performed in patients with concurrent diagnosis of cancer. Cancer and its therapy may affect the choice and timing of aortic valve therapy and its outcome. The risk assessment involved is less straightforward and seems to be different in some aspects compared to the older and often sicker population.

Future prospective studies are necessary and would be important to correctly choose those cancer patients who need the procedure most and in whom the advantage despite the malignancy is bigger and to better choose the correct timing with respect to the disease and its treatment.

Dan Gilon