Transcatheter aortic valve implantation in patients with small aortic annuli using a 20 mm balloon-expanding valve
| Autor: | Emilie Pelletier-Beaumont, Alfredo Giuseppe Cerillo, Martin Thoenes, Josep Rodés-Cabau, Kaj Erik Klaaborg, Simon Redwood, Caterina Gandolfo, Marc P. Pelletier, Harindra C. Wijeysundera, Rishi Puri, Pieter R. Stella, Richard Edwards, Douglas F Muir, Matthias Götberg, Asim N. Cheema, Philippe Pibarot, Francesco Meucci, Jonathan Byrne, Marko P. Virtanen, Jan Malte Sinning, Christophe Dubois, Verena Veulemans, Hélène Eltchaninoff, Ander Regueiro, Roberto Blanco-Mata, Hardy Baumbach, Ralf Müller, Leo Ihlberg |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Canada medicine.medical_specialty Transcatheter aortic Aortic Valve Insufficiency Hemodynamics Postoperative Hemorrhage 030204 cardiovascular system & hematology Prosthesis Design Balloon Transcatheter Aortic Valve Replacement 03 medical and health sciences 0302 clinical medicine Aortic valve replacement Internal medicine Journal Article medicine Humans In patient Hospital Mortality Registries 030212 general & internal medicine Heart valve Stroke Aged 80 and over Medicine(all) business.industry Aortic Valve Stenosis medicine.disease 3. Good health Surgery Europe Multicenter Study Stenosis Treatment Outcome medicine.anatomical_structure Aortic Valve Heart Valve Prosthesis Cardiology Feasibility Studies Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Heart, 103(2), 148. BMJ Publishing Group |
| ISSN: | 1468-201X 1355-6037 |
| DOI: | 10.1136/heartjnl-2016-309707 |
| Popis: | While transcatheter aortic valve implantation (TAVI) is established for treating high-operative risk surgical aortic valve replacement candidates, until recently the smallest transcatheter heart valve (THV) measured 23 mm, posing greater risk for annular rupture and THV failure in patients with aortic stenosis (AS) with small aortic annuli (≤20 mm).In the setting of a multicentre registry, we report on the safety, efficacy and early clinical outcomes of the SAPIEN XT 20 mm balloon-expanding THV.Among TAVI 55 recipients (n=30 for native AS, n=25 for a valve-in-valve procedure (V-in-V)), median age and Society of Thoracic Surgeons score were 85 (81 to 87) years and 7.8 (4.7 to 12.4)%, respectively. Mean and minimum annular diameters were 19±1 and 17±2 mm, respectively, in native patients with AS, and 17±1 mm (internal diameter) in V-in-V recipients. Successful device implantation rate was 96%, with no procedural-related death. Overall in-hospital-30-day death, stroke and major bleeding rates were 5%, 2% and 9%, respectively. In native AS TAVI recipients, mean transaortic gradient decreased from 54±20 to 12±5 mm Hg (p0.001), and from 45±17 to 24±8 mm Hg (p0.001) in V-in-V recipients. Severe prosthesis-patient mismatch (PPM) rates were 10% and 48% in native AS and V-in-V TAVI recipients, respectively (p=0.03). Post-TAVI, the rate of moderate aortic regurgitation was 7% and 0% in native AS and V-in-V TAVI recipients, respectively.TAVI with the 20 mm SAPIEN XT THV appears safe and technically feasible, with acceptable short-term clinical outcomes and low rates of severe PPM in those with native AS. |
| Databáze: | OpenAIRE |
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