BACKGROUND: Transcatheter aortic valve implantation (TAVI) has been proposed as a therapeutic option for high-risk or inoperable patients with severe symptomatic aortic valve stenosis. The aim of this multicenter study was to assess early and medium term outcomes of transapical aortic valve implantation (TA-TAVI). METHODS: From April 2008 through June 2012, a total of 774 patients were enrolled in the Italian Registry of Trans-Apical Aortic Valve Implantation (I-TA). Twenty-one centers were included in the I-TA registry. Outcomes were also analyzed according to the impact of the learning curve (first 50% cases versus second 50% cases of each center) and of the procedural volume (high-volume versus low-volume centers). RESULTS: Mean age was 81.0±6.7 years, mean logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE) I, EuroSCORE II, and The Society of Thoracic Surgeons risk score were 25.6%±16.3%, 9.4%±11.0%, and 10.6%±8.5%, respectively. Median follow-up was 12 months (range, 1 to 44). Thirty-day mortality was 9.9% (77 patients). Overall 1-, 2-, and 3-year survival was 81.7%±1.5%, 76.1%±1.9%, and 67.6%±3.2%, respectively. Thirty-day mortality of the first 50% patients of each center was higher when compared with the second half (p=0.04) but 3-year survival was not different (p=0.64). Conversely, 30-day mortality at low-volume centers versus high-volume centers was similar (p=0.22). At discharge, peak and mean transprosthetic gradients were 21.0±10.3 mm Hg and 10.2±4.1 mm Hg, respectively. These values remained stable 12 and 24 months after surgery. CONCLUSIONS: Transapical TAVI provides good results in terms of early and midterm clinical and hemodynamic outcomes. Thus it appears to be a safe and effective alternative treatment for patients who are inoperable or have high surgical risk.
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has been proposed as a therapeutic option for high-risk or inoperable patients with severe symptomatic aortic valve stenosis. The aim of this multicenter study was to assess early and medium term outcomes of transapical aortic valve implantation (TA-TAVI). METHODS: From April 2008 through June 2012, a total of 774 patients were enrolled in the Italian Registry of Trans-Apical Aortic Valve Implantation (I-TA). Twenty-one centers were included in the I-TA registry. Outcomes were also analyzed according to the impact of the learning curve (first 50% cases versus second 50% cases of each center) and of the procedural volume (high-volume versus low-volume centers). RESULTS: Mean age was 81.0±6.7 years, mean logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE) I, EuroSCORE II, and The Society of Thoracic Surgeons risk score were 25.6%±16.3%, 9.4%±11.0%, and 10.6%±8.5%, respectively. Median follow-up was 12 months (range, 1 to 44). Thirty-day mortality was 9.9% (77 patients). Overall 1-, 2-, and 3-year survival was 81.7%±1.5%, 76.1%±1.9%, and 67.6%±3.2%, respectively. Thirty-day mortality of the first 50% patients of each center was higher when compared with the second half (p=0.04) but 3-year survival was not different (p=0.64). Conversely, 30-day mortality at low-volume centers versus high-volume centers was similar (p=0.22). At discharge, peak and mean transprosthetic gradients were 21.0±10.3 mm Hg and 10.2±4.1 mm Hg, respectively. These values remained stable 12 and 24 months after surgery. CONCLUSIONS: Transapical TAVI provides good results in terms of early and midterm clinical and hemodynamic outcomes. Thus it appears to be a safe and effective alternative treatment for patients who are inoperable or have high surgical risk.
Authors: Francesco Onorati; Augusto D'Onofrio; Fausto Biancari; Stefano Salizzoni; Marisa De Feo; Marco Agrifoglio; Giovanni Mariscalco; Vincenzo Lucchetti; Antonio Messina; Francesco Musumeci; Giuseppe Santarpino; Giampiero Esposito; Francesco Santini; Paolo Magagna; Cesare Beghi; Marco Aiello; Ester Dalla Ratta; Carlo Savini; Giovanni Troise; Mauro Cassese; Theodor Fischlein; Mattia Glauber; Giancarlo Passerone; Giuseppe Punta; Tatu Juvonen; Ottavio Alfieri; Davide Gabbieri; Domenico Mangino; Andrea Agostinelli; Ugolino Livi; Omar Di Gregorio; Alessandro Minati; Mauro Rinaldi; Gino Gerosa; Giuseppe Faggian Journal: Interact Cardiovasc Thorac Surg Date: 2016-03-14
Authors: G Krasopoulos; F Falconieri; U Benedetto; J Newton; R Sayeed; R Kharbanda; A Banning Journal: J Cardiothorac Surg Date: 2016-11-29 Impact factor: 1.637
Authors: Luigi Biasco; Enrico Ferrari; Giovanni Pedrazzini; Francesco Faletra; Tiziano Moccetti; Francesco Petracca; Marco Moccetti Journal: Front Cardiovasc Med Date: 2018-07-17
Authors: Farid Foroutan; Gordon H Guyatt; Kathleen O'Brien; Eva Bain; Madeleine Stein; Sai Bhagra; Daegan Sit; Rakhshan Kamran; Yaping Chang; Tahira Devji; Hassan Mir; Veena Manja; Toni Schofield; Reed A Siemieniuk; Thomas Agoritsas; Rodrigo Bagur; Catherine M Otto; Per O Vandvik Journal: BMJ Date: 2016-09-28