Abstract 16690: Transcatheter Aortic Valve Implantation (TAVI): A Five Year Single-Center Experience
Background: Transcatheter aortic valve implantation (TAVI) has evolved to an accepted treatment option for high-risk patients with severe aortic stenosis. We report our five year experience comparing transfemoral (TF) and transapical (TA) TAVI using the the balloon-expandable Edwards and the self-expandable Medtronic-CoreValve (MCV) prosthesis.
Methods: From 01/2006 to 05/2011, 329 high-risk patients underwent TAVI (TF: n=223 [Edwards n=135; MCV n=98]; TA: n=106). We analysed procedural data and outcome of this cohort.
Results: Patients undergoing TA-TAVI were older (82±4 vs. 80±6yrs; p=0.071) and significantly sicker than TF-TAVI patients (EuroScore 33±15% vs. 19±13%; p<0.001). Procedural success was achieved in all but four patients (TF: n=2; TA n=2, p=0.740) .We found a non-significant trend towards a higher 30-day mortality (11% vs. 8%, p=0.270) and cumulative mortality in the sicker TA-TAVI patient cohort (figure 1). Interestingly, in both groups there was an apparent learning curve which was reflected in a significantly better survival (30-day mortality: TF: 18%vs.8%; p=0.034; TA: 31%vs.8%; p=0.003) in the second half of each group (figure 2). There was no signifcant difference between the Edwards and Corevalve prosthesis in the transfemoral approach. Long term mortality was mainly due to non-cardiac deaths.
Conclusion: TAVI can be performed with high procedural success rates after an inherent learning curve. As expected by different baseline characteristics, TA-TAVI patients had a higher mortality than TF-TAVI patients. Overall, the five year data show positive results of this novel treatment.
- © 2011 by American Heart Association, Inc.