Abstract 13814: Clinical and Hemodynamic Outcomes of Transapical Aortic Valve Implantation: Two Years Experience in 155 Patients
Trans-apical aortic valve implantation (TA-TAVI) is a good alternative in patients with severe aortic valve stenosis (AS) who are inoperable or have a high surgical risk. Few data exist about hemodynamic behavior and mid-term results of TA-TAVI. Aim of this multicenter study was to assess early and mid-term clinical and hemodynamic outcomes after TA-TAVI. From May 2008 to May 2010, 155 consecutive inoperable or high risk patients (70.9 % female patients) underwent TA-TAVI with the Edwards Sapien xenograft at four different institutions. Indications for TA-TAVI were: severe symptomatic AS (area <0.8 cm2) and logistic Euroscore >20% or porcelain aorta in patients with severe aorto-iliac disease. Mean age was 81±6 years. Mean logistic Euroscore was 22±12%. Previous PCI with stent implantation was performed in 34 patients (21.9%). All patients were prospectively followed-up with clinical and echocardiographic evaluation 1, 3 and every 6 months after surgery. Mean follow-up was 275±159 days (1–24 months), total cumulative follow-up was 117 pt-years. Transapical delivery was successful in all patients. Valve sizes 23 and 26 were implanted in 53 (34.2%) and 102 (65.8%) patients, respectively. Thirty-day mortality was 3.2% (5 patients). Median stay in the post-operative intensive care unit was 2 days. Permanent pace-maker implantation and dyalisis were required in 7 (4.5%) and 14 (9.0%) patients, respectively. Moderate perivalvular leak was present in 11 (7.1%) patients. Late mortality occurred in 8 patients (6.8% pt-years). Kaplan-Meier survival at 2 years was 90.6±2.5%. Hemodynamic results are shown in table 1. We did not observe structural valve deterioration nor other valve-related adverse event during follow-up. In conclusion, our data suggest that TA-TAVI provides excellent mid-term clinical and hemodynamic results in high risk patients. Further observations are warranted to assess long term durability and freedom from valve-related adverse events.
- © 2010 by American Heart Association, Inc.