BACKGROUND: This report analyzes a single institution's results with transapical aortic valve implantation (TAVI) from an initial series of patients over 5 years. METHODS: A series of 100 patients underwent TAVI at our institution between January 2005 and December 2008. The mean patient age was 85 ± 6 years. All patients had a high perioperative risk for aortic valve replacement (mean logistic EuroSCORE of 36% ± 12%; Society of Thoracic Surgeons [STS] score 16% ± 3%). Clinical and echocardiographic variables were entered prospectively into a database. Late follow-up for survival, clinical outcomes including the New York Heart (NYHA) Association functional class, and echocardiographic assessment was 100% complete. RESULTS: After a mean follow-up of 3.8 ± 2 years, overall mortality was 13% (n = 13/100), 30-day mortality was 8% (8/100), and late mortality was 5% (5/100). There were 2 perioperative repeated thoracotomies for bleeding, 2 intraoperative conversions, 1 prosthesis embolization, and 2 cases of impairment of coronary arteries. The causes of late mortality were cardiac failure (n = 2), respiratory failure (n = 1), renal failure (n = 1), and cancer (n = 1). At late follow-up there were no cases of endocarditis or stroke in any of the patients. None of the valves showed structural valve degeneration. NYHA functional class improved from 3.4 ± 0.4 before operation to 1.9 ± 0.5 at late follow-up (p = 0.02). Only 4 patients did not improve in functional class. CONCLUSIONS: Midterm outcomes after TAVI in high-risk patients at our institution show an improvement in functional capacity, with a good survival rate. Valve degeneration is not an issue at midterm follow-up.
BACKGROUND: This report analyzes a single institution's results with transapical aortic valve implantation (TAVI) from an initial series of patients over 5 years. METHODS: A series of 100 patients underwent TAVI at our institution between January 2005 and December 2008. The mean patient age was 85 ± 6 years. All patients had a high perioperative risk for aortic valve replacement (mean logistic EuroSCORE of 36% ± 12%; Society of Thoracic Surgeons [STS] score 16% ± 3%). Clinical and echocardiographic variables were entered prospectively into a database. Late follow-up for survival, clinical outcomes including the New York Heart (NYHA) Association functional class, and echocardiographic assessment was 100% complete. RESULTS: After a mean follow-up of 3.8 ± 2 years, overall mortality was 13% (n = 13/100), 30-day mortality was 8% (8/100), and late mortality was 5% (5/100). There were 2 perioperative repeated thoracotomies for bleeding, 2 intraoperative conversions, 1 prosthesis embolization, and 2 cases of impairment of coronary arteries. The causes of late mortality were cardiac failure (n = 2), respiratory failure (n = 1), renal failure (n = 1), and cancer (n = 1). At late follow-up there were no cases of endocarditis or stroke in any of the patients. None of the valves showed structural valve degeneration. NYHA functional class improved from 3.4 ± 0.4 before operation to 1.9 ± 0.5 at late follow-up (p = 0.02). Only 4 patients did not improve in functional class. CONCLUSIONS: Midterm outcomes after TAVI in high-risk patients at our institution show an improvement in functional capacity, with a good survival rate. Valve degeneration is not an issue at midterm follow-up.
Authors: Suengwon Lee; Robert J Levy; Abigail J Christian; Stanley L Hazen; Nathan E Frick; Eric K Lai; Juan B Grau; Joseph E Bavaria; Giovanni Ferrari Journal: J Am Heart Assoc Date: 2017-05-08 Impact factor: 5.501
Authors: Caroline A Kim; Suraj P Rasania; Jonathan Afilalo; Jeffrey J Popma; Lewis A Lipsitz; Dae Hyun Kim Journal: Ann Intern Med Date: 2014-02-18 Impact factor: 25.391
Authors: Nestoras Papadopoulos; Ali El-Sayed Ahmad; Marlene Thudt; Stephan Fichtlscherer; Patrick Meybohm; Christian Reyher; Anton Moritz; Andreas Zierer Journal: J Cardiothorac Surg Date: 2016-04-11 Impact factor: 1.637