Short- and mid-term safety and effectiveness of transcatheter aortic valve implantation in a failing surgical aortic bioprosthesis
| Autor: | Gerhard Schuler, Robert Bauernschmitt, Sea Hing Ong, Ralf Mueller |
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| Rok vydání: | 2012 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Cardiac Catheterization medicine.medical_specialty Logistic euroscore Transcatheter aortic medicine.medical_treatment Regurgitation (circulation) Prosthesis Nyha class Internal medicine medicine.artery Humans Medicine In patient Prospective Studies Aged Bioprosthesis Heart Valve Prosthesis Implantation Aorta business.industry General Medicine Surgical risk Prosthesis Failure Surgery Treatment Outcome Aortic Valve Heart Valve Prosthesis Cardiology Feasibility Studies Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Journal of Cardio-Thoracic Surgery. 42:268-276 |
| ISSN: | 1873-734X 1010-7940 |
| Popis: | OBJECTIVES: The feasibility of transcatheter aortic valve implantation (TAVI) in patients with a failing surgical aortic bioprosthesis has been reported from single centres. We present results from a multi-centre feasibility study in such patients followed for 1 year after TAVI. METHODS: This study evaluated 18 patients undergoing implantation with the 18-Fr CoreValve TAVI prosthesis in a failing surgical aortic bioprosthesis at three centres in Germany. Subject inclusion requirements included ≥75 years old and either surgical risk with logistic European System for Cardiac Operative Risk Evaluation ≥15% or ≥1 high-risk co-morbidity. RESULTS: Implanted subjects were 79 ± 4 years old, 67% males, 78% NYHA Class III/IV, with logistic EuroSCORE 34 ± 14, and had failed surgical bioprostheses from six manufacturers. The procedure was considered technically successful in 94% (17/18) of cases. One subject was converted to surgery during the procedure. Mortality at 30 days and 1 year was 11% (2/18) and 28% (5/18), respectively. Two cardiac deaths occurred, including 1 within 30 days. Two subjects had strokes, both within 30 days. After 30 days and 1 year, respectively, 86 and 73% of subjects improved at least 1 NYHA class and the remainder had no change. No aortic regurgitation was reported beyond mild (Grade 1) at 6- and 12-month follow-up. CONCLUSIONS: Most patients with a failing aortic surgical bioprosthesis were successfully implanted with a TAVI prosthesis in this multi-centre feasibility study. Outcomes at 30 days were within expectations for this very high-risk subgroup and improvements were sustained through 12 months. |
| Databáze: | OpenAIRE |
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