Self-Expandable Transcatheter Aortic Valve Implantation Outcomes: Findings From the Western Region of Saudi Arabia.

Autor:	Albugami S; Cardiology, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU.; Cardiology, King Faisal Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, SAU., Al-Husayni F; Internal Medicine, King Abdullah International Medical Research Center, Jeddah, SAU.; Internal Medicine, National Guard Hospital, King Abdulaziz Medical City, Jeddah, SAU., Alfouti M; Internal Medicine, National Guard Hospital, King Abdulaziz Medical City, Jeddah, SAU., Algahtani M; Interventional Cardiology, National Guard Hospital, Riyadh, SAU., Alansari W; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU., Hanawi M; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU., Albokhari A; Internal Medicine, Hera General Hospital, Makkah, SAU., Alkashkari W; Cardiology, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU.; Cardiology, King Faisal Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, SAU., Mufti HN; Medicine, King Abdullah International Medical Research Center, Jeddah, SAU.; Cardiac Surgery, King Faisal Cardiac Center, King Abdullah Medical City, Jeddah, SAU.; Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU., Krimly A; Cardiology, King Faisal Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, SAU., Alameen W; Cardiology, King Faisal Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, SAU., Albawardy R; Cardiology, King Faisal Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, SAU., Alsaiedi A; Cardiology, King Faisal Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, SAU.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2021 Sep 25; Vol. 13 (9), pp. e18272. Date of Electronic Publication: 2021 Sep 25 (Print Publication: 2021).
DOI:	10.7759/cureus.18272
Abstrakt:	Background and objective The prevalence of aortic stenosis in Saudi Arabia is expected to increase owing to the rise in the life expectancy of the population. Such increase is expected to be met with higher demand for interventions including transcatheter aortic valve implantation (TAVI). In this study, we aimed to identify the outcomes of this procedure among the population of the Western region of Saudi Arabia. Methods This was a retrospective observational study involving patients who underwent TAVI at the King Faisal Cardiac Center (KFCC), Jeddah, Saudi Arabia from June 2018 to January 2020. All patients who had undergone TAVI were included, and patients who were lost to follow-up for more than 90 days were excluded. The collected data included sociodemographic characteristics, peri-procedural assessment, and outcomes within 90 days. Results The study included a total of 52 patients. There were 28 males (53.8%) and 24 females (46.2%). The mean age of the cohort was 78 years. Type two diabetes mellitus was present in 67.3%, and hypertension and dyslipidemia were seen in 80.8% of patients. Coronary diseases were seen in 55.8%. The majority had prior percutaneous coronary intervention (PCI) (53.8%) and 3.8% had coronary artery bypass grafting (CABG). Twenty patients (38.5%) had heart failure. Atrial fibrillation was encountered in 13 patients (25%). Chronic kidney disease was described in nine (17.3%) patients, and four (7.7%) were on regular hemodialysis. The median Society of Thoracic Surgery (STS) risk score was 2.4 (IQR: 1.97-5). High STS scores (>8) were only seen in 9% of the patients. The success rate was 98%, and the in-hospital mortality rate was 3.8%. Vascular complications were seen in eight patients (15.4%), and the majority of them were minor. One patient (1.9%) had a major vascular complication. There was a tendency toward high blood transfusions (19.2%). Clinically manifest stroke was seen in three patients (5.8%). Eight patients (15.4%) had post-procedure complete heart block (CHB). Endocarditis was seen in two patients (3.8%). Thirty-day cardiac readmission was observed in 17.3% of patients, and acute kidney injury was seen in eight patients (15.4%). Mild aortic regurgitation was seen in 51.9% of the patients, but moderate or severe aortic insufficiency (AI) was not encountered. Conclusion Transfemoral TAVI using a self-expandable valve is a safe and feasible procedure at KFCC, an intermediate-sized center. Our data is comparable to local and international centers of similar size. Program sustainability depends on the development of robust referral networks and implementing regulatory quality and patient safety standards. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2021, Albugami et al.)
Databáze:	MEDLINE
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