Medium term outcomes of transapical aortic valve implantation: results from the Italian Registry of Trans-Apical Aortic Valve Implantation
| Autor: | Alfredo Giuseppe Cerillo, Carlo Savini, Omar Di Gregorio, Giovanni Domenico Cresce, Andrea Agostinelli, Micaela Cioni, Mauro Rinaldi, Marco Agrifoglio, Mauro Cassese, Paolo Tartara, Chiara Zanchettin, Giuseppe Punta, Giuseppe Gatti, Claudia Filippini, Marco Aiello, Davide Gabbieri, Augusto D'Onofrio, Stefano Salizzoni, Giuseppe Faggian, Linda Cota, Enzo Mazzaro, Giampaolo Luzi, Gino Gerosa |
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| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Aortic valve Cardiac Catheterization medicine.medical_specialty Hemodynamics Kaplan-Meier Estimate Risk Assessment Severity of Illness Index Medium term surgery Internal medicine medicine Humans surgery Heart Valve Prosthesis Heart Valve Prosthesis Implantation Humans Italy Hospital Mortality Prospective Studies Registries Aged Proportional Hazards Models Aged 80 and over Heart Valve Prosthesis Implantation Framingham Risk Score business.industry Endovascular Procedures Age Factors EuroSCORE Aortic Valve Stenosis medicine.disease Surgery Survival Rate Logistic Models Treatment Outcome medicine.anatomical_structure Multicenter study Italy Echocardiography Aortic valve stenosis Heart Valve Prosthesis Multivariate Analysis Cardiology Female Operative risk Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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