Transcatheter aortic valve implantation in patients with high-risk aortic stenosis: a clinical follow-up.


Toraman F.

TURKISH THORACIC JOURNAL, cilt.19, ss.495-502, 2011 (SCI Expanded İndekslerine Giren Dergi)

  • Cilt numarası: 19 Konu: 4
  • Basım Tarihi: 2011
  • Dergi Adı: TURKISH THORACIC JOURNAL
  • Sayfa Sayıları: ss.495-502

Özet

Background: This study aims to evaluate early- and mid-term results of our patients who underwent transluminal aortic valve implantation (TAVI). Methods: The early- and mid-term results of 10 patients (7 females, 3 males; mean age 80.4±6.7 years; range 64 to 88 years) with high surgical risk who underwent the TAVI procedure in our clinic between January 2010 and April 2011 were evaluated. All of our patients were implanted with Edwards Sapien bioprosthetic valves through the transfemoral approach and followed-up for 6.1±5.2 months. Results: Before the procedure, the mean functional class was NYHA 3.8±0.4, the mean aortic valve area (AVA) was 0.6±0.1cm2 , the left ventricular ejection fraction (LVEF) was %55.4±9.8 and the mean peak (PAG) and mean valvular gradients (MAG) were 94.3±24.2 and 54.5±17.7 mmHg, respectively. No additional interventional procedure was required during this stage. The technical success rate was 100%, and a single valve was implanted in all patients. Neither mortality nor major strokes were observed during the follow-up period. Following the TAVI procedure, the NYHA decreased to 1.9±0.6 (p<0.01), AVA increased to 1.6±0.2 cm2 (p<0.01), LVEF increased to 58.8±8.0% (p>0.05), and PAG and MAG decreased to 25.6±5.1 and 14.1±3.3 mmHg, respectively (p<0.01). One patient developed acute occlusion of the left main coronary ostium which was treated with a successful stenting procedure. In one patient, vascular repair was performed during the procedure due to a laceration in the femoral access site. In two patients, transient bundle branch blocks occurred, but no permanent AV blocks were observed and none of the patients required permanent pacemaker implantation. Conclusion: In aortic stenosis patients with high open surgery risk, TAVI is a rather safe method in terms of procedural success. The early- and mid-term cardiovascular results following TAVI can be considered to be successful. Long-term follow-up studies with large series are needed to determine the safety and durability of the TAVI procedure.