Abstract 3035: Transapical Aortic Valve Implantation - Current Results
Objective: The aim of this study was to evaluate the current outcome of minimally invasive transapical aortic valve implantation.
Methods: A total of 237 high risk patients (total experience=TE) with symptomatic aortic stenosis received transapical aortic valve implantation from 02/2006 until 06/2009 using the Edwards SAPIEN transcatheter xenograft. Patient age was 82±6 years, 70% were female. Logistic EuroSCORE was 32±16%, additive EuroSCORE 12±2 and STS score was 12±7%. Patients treated more recently in the “post-market approval” period since 04/2008 (recent experience (RE), n=117) had the same age and a comparable risk profile (logistic EuroSCORE 34±17%, additive EuroSCORE 12±2 and STS score 10±6%).
Results: Transapical aortic valve implantation was performed completely off-pump in 91% (TE) and 99% (RE). Two patients treated under resuscitation died and five patients required perioperative conversion to full sternotomy. Overall survival at 30 days was 91% (TE) versus 96% (RE), survival at 6 months was 77% (TE) versus 85% (RE) and survival at one year was 74% (TE) versus 77% (RE), respectively. Two patients suffered secondary stroke on postoperative day 1 and 2 with good functional recovery.
Conclusions: Transapical aortic valve implantation can be performed with excellent outcome in high risk patients with aortic stenosis. Optimal imaging and a team approach are essential for success. Recent results indicate a persistently high risk profile of the included patients and improved outcomes based on initial learnings and technical refinements of the procedure.