Transcatheter aortic valve implantation: Single center experience with mid-term follow-up

• Published in: Journal Of The Saudi Heart Association Vol. 25; no. 2; pp. 129 - 130
• Main Authors: Khaliel, Feras, Alhalees, Zohair, Alarfaj, Salman, Alsergani, Hani, Shahed, Maie, Alburaiki, Jehad
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01.04.2013
• ISSN: 1016-7315; 2212-5043
• DOI: 10.1016/j.jsha.2013.03.071

Transcatheter aortic-valve implantation (TAVI) is an emerging intervention for the treatment of high-risk patients with severe aortic stenosis and coexisting illnesses. Between August 2009 and May 2012, we have conducted a retrospective study underwent a balloon expandable transcatheter xenograft (Edwards SAPIEN®) and evaluated the intermediate-term all cause mortality. Average STS and EuroSCORE II predicted risk for mortality was 18.4±8.9% and 7.6±5.5%, respectively. The end points included feasibility, safety, efficacy, and durability. A total of 27 consecutive patients underwent TAVI. Nine (33.3%) patients among them had it through the trans-apical approach. The mean age was 76±8 years; 41% of the patients were females. There was 100% successful implantation. Hospital and one-year mortality were 2 (7.4%) and 4 (14.8%), respectively. At 1 year, the incidence of stroke was 1 (3.7%), infection 6 (22%), AV block 2 (7.4%), severe bleeding 2 (7.4%), vascular complication (14.8%), and the incidence of periprosthetic aortic regurgitation (<2) was 5 (18.5%). No patient been converted to open surgery. There was a significant improvement of patient left ventricular function post TAVI (p=0.001), and of aortic valve area (AVA) with mean 0.4±01cm2 ranging from 0.2 to 0.9 cm2 pre-and 1±0.3cm2 ranging from 1 to1.9cm2 post-TAVI (p=0.0001). The aortic pressure gradients have improved significantly from 45±11mmHg pre-to 8.5±5.5mmHg post-implantation (p=0.0001). For all patients the average length of follow-up by echocardiography was 346 days and was 100% completed. TAVI has provided good results in the initial 27 patients. However, The use of transcatheter aortic valve implantation should be restricted to the inoperable high-risk patients.