BACKGROUND: For an increasing number of patients with severe symptomatic aortic stenosis, advanced age and comorbidity make the risk of surgery unacceptably high. In such cases, catheter-based techniques for aortic valve implantation are a new therapeutic option. In this paper, we describe the initial results obtained at the German Heart Center, Munich, with a new technique of this kind. METHODS: From June 2007 to September 2008, 152 patients underwent transcatheter aortic valve implantation at the German Heart Center, Munich (121 transfemorally, 26 transapically, and 5 through other sites of access). In this technique, a stent-mounted valve is crimped onto a catheter and then positioned and deployed in the aortic annulus under fluoroscopic control. RESULTS: The 30-day mortality was 11.8% in this group of patients at high risk. The more common post-procedural complications were third-degree atrioventricular block leading to pacemaker implantation (31/152, 20%), vascular complications (25/152, 16%), and cerebrovascular events (8/152, 5%). Six months after the procedure, the patients had recovered clinically to a considerable extent, and the implanted prostheses exhibited good hemodynamic function. CONCLUSIONS: The technical feasibility of catheter-based aortic valve implantation has been demonstrated at multiple centers around the world. Its indications still need to be refined on the basis of the short- and long-term results of the randomized and observational studies that are currently in progress. It is already apparent that catheter-based aortic valve implantation can bring about clinical improvement in patients who are deemed ineligible for open surgery.
BACKGROUND: For an increasing number of patients with severe symptomatic aortic stenosis, advanced age and comorbidity make the risk of surgery unacceptably high. In such cases, catheter-based techniques for aortic valve implantation are a new therapeutic option. In this paper, we describe the initial results obtained at the German Heart Center, Munich, with a new technique of this kind. METHODS: From June 2007 to September 2008, 152 patients underwent transcatheter aortic valve implantation at the German Heart Center, Munich (121 transfemorally, 26 transapically, and 5 through other sites of access). In this technique, a stent-mounted valve is crimped onto a catheter and then positioned and deployed in the aortic annulus under fluoroscopic control. RESULTS: The 30-day mortality was 11.8% in this group of patients at high risk. The more common post-procedural complications were third-degree atrioventricular block leading to pacemaker implantation (31/152, 20%), vascular complications (25/152, 16%), and cerebrovascular events (8/152, 5%). Six months after the procedure, the patients had recovered clinically to a considerable extent, and the implanted prostheses exhibited good hemodynamic function. CONCLUSIONS: The technical feasibility of catheter-based aortic valve implantation has been demonstrated at multiple centers around the world. Its indications still need to be refined on the basis of the short- and long-term results of the randomized and observational studies that are currently in progress. It is already apparent that catheter-based aortic valve implantation can bring about clinical improvement in patients who are deemed ineligible for open surgery.
Authors: John G Webb; Mann Chandavimol; Christopher R Thompson; Donald R Ricci; Ronald G Carere; Brad I Munt; Christopher E Buller; Sanjeevan Pasupati; Samuel Lichtenstein Journal: Circulation Date: 2006-02-06 Impact factor: 29.690
Authors: John G Webb; Sanjeevan Pasupati; Karin Humphries; Christopher Thompson; Lukas Altwegg; Robert Moss; Ajay Sinhal; Ronald G Carere; Brad Munt; Donald Ricci; Jian Ye; Anson Cheung; Sam V Lichtenstein Journal: Circulation Date: 2007-07-23 Impact factor: 29.690
Authors: Alain Cribier; Helene Eltchaninoff; Assaf Bash; Nicolas Borenstein; Christophe Tron; Fabrice Bauer; Genevieve Derumeaux; Frederic Anselme; François Laborde; Martin B Leon Journal: Circulation Date: 2002-12-10 Impact factor: 29.690
Authors: Robert O Bonow; Blase A Carabello; Chatterjee Kanu; Antonio C de Leon; David P Faxon; Michael D Freed; William H Gaasch; Bruce Whitney Lytle; Rick A Nishimura; Patrick T O'Gara; Robert A O'Rourke; Catherine M Otto; Pravin M Shah; Jack S Shanewise; Sidney C Smith; Alice K Jacobs; Cynthia D Adams; Jeffrey L Anderson; Elliott M Antman; David P Faxon; Valentin Fuster; Jonathan L Halperin; Loren F Hiratzka; Sharon A Hunt; Bruce W Lytle; Rick Nishimura; Richard L Page; Barbara Riegel Journal: Circulation Date: 2006-08-01 Impact factor: 29.690
Authors: Josep Rodés-Cabau; Eric Dumont; Robert De LaRochellière; Daniel Doyle; Jerome Lemieux; Sebastien Bergeron; Marie-Annick Clavel; Jacques Villeneuve; Kathleen Raby; Olivier F Bertrand; Philippe Pibarot Journal: Am J Cardiol Date: 2008-09-05 Impact factor: 2.778