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  • Oral presentation
  • Open Access

Mid-term results of TAVI in high-risk patients: data from a single center study

  • 1Email author,
  • 1,
  • 1,
  • 1,
  • 1 and
  • 1
Journal of Cardiothoracic Surgery20138 (Suppl 1) :O315

https://doi.org/10.1186/1749-8090-8-S1-O315

  • Published:

Keywords

  • Aortic Valve
  • Aortic Stenosis
  • Aortic Valve Replacement
  • Transcatheter Aortic Valve Implantation
  • Acute Heart Failure

Background

Transcatheter aortic valve implantation (TAVI) has become a method of choice in repair of valvular aortic stenosis, especially in group of patients with high surgical risk.

Aim

The objective was to evaluate the immediate and mid-term results of applying TAVI in aortic valve surgery.

Methods

80 patients with a median age of 78 ± 5.2 years were included. All patients had severe aortic stenosis. According to the echo an average gradient of systolic pressure on the aortic valve was >20% by EuroSCORE and > 10% by STS. We have implanted Edwards Sapiens/Sapiens XT or Medtronic CoreValve bioprostheses. In 58 cases implantation was performed through transfemoral access (including 30 Edwards Sapien cases) and in 17 cases- transapical access was used due to vascular abnormalities. In the rest 5 patients we used direct transaortic (4 cases) and in 1 case - transsubclavian approach.

Results

Intraoperative mortality was 1.25%: 1 patient (women) died with symptoms of acute heart failure. Total 30 days mortality rate was 5%: 2 patients died within 7 days after TAVI - IM and other 2 patients developed cardiogenic shock. Incidence of non-fatal stroke was 2.5%. In 2 patients the procedure of hemodialysis needed to be performed because of acute contrast-induced renal injury. Other patients had no significant complications. The AMPG after Edwards Sapien and Medtronic CoreValve implantations were 10,9±3,5 and 14,3±5,4 mm Hg respectively. The incidence of paravalvular leak of 2 degree had a tendency to be higher in CoreValve than in Edwards Sapien subgroup (15% vs. 5%). Nevertheless, by the end of 1-year follow-up only 2 patients had residual aortic regurgitation >2 degree (CoreValve). In 5 patients after CoreValve implantation (25%) - need of permanent pacemaker. The overall mortality rate by the end of 1-year was 12% with no procedure-related deaths.

Conclusion

TAVI can be considered as a real alternative to traditional aortic valve replacement in high-risk patients.

Authors’ Affiliations

(1)
Cardiovascular Surgery, Russian Cardiology Research Center Moscow, Russian Federation

Copyright

© Akchurin et al; licensee BioMed Central Ltd. 2013

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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