Initial experience of two national centers in transcatheter aortic prosthesis implantation

Arq Bras Cardiol. 2014 Apr;102(4):336-44. doi: 10.5935/abc.20140043.
[Article in English, Portuguese]

Abstract

Background: Transcatheter aortic valve implantation is an effective alternative to surgical treatment of severe aortic stenosis in patients who are inoperable or at high surgical risk.

Objectives: To report the immediate and follow-up clinical and echocardiographic results of the initial experience of transcatheter aortic valve implantation.

Methods: From 2009 June to 2013 February, 112 patients underwent transcatheter aortic valve implantation.

Results: Mean age was 82.5 ± 6.5 years, and the logistic EuroSCORE was 23.6 ± 13.5. Procedural success was 84%. After the intervention, a reduction in the mean systolic gradient was observed (pre: 54.7 ± 15.3 vs. post: 11.7 ± 4.0 mmHg; p < 0.01). Cerebrovascular accidents occurred in 3.6%, vascular complications in 19% and permanent pacemaker was required by 13% of the patients. Thirty-day mortality and at follow-up of 16 ± 11 months was 14% and 8.9% respectively. The presence of chronic obstructive pulmonary disease was the only predictor of mortality at 30 days and at follow-up. During follow up, aortic valve area and mean systolic gradient did not change significantly.

Conclusions: Transcatheter aortic valve implantation is an effective and safe procedure for the treatment of aortic stenosis in high-surgical risk or inoperable patients. The presence of chronic obstructive pulmonary disease was the only independent predictor of mortality identified both in the first month post-intervention and at follow-up.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aortic Valve Stenosis / diagnostic imaging
  • Aortic Valve Stenosis / mortality
  • Aortic Valve Stenosis / surgery*
  • Cardiac Catheterization / adverse effects
  • Cardiac Catheterization / methods*
  • Cardiac Catheterization / mortality
  • Echocardiography, Doppler
  • Female
  • Follow-Up Studies
  • Heart Valve Prosthesis Implantation / adverse effects
  • Heart Valve Prosthesis Implantation / methods*
  • Heart Valve Prosthesis Implantation / mortality
  • Heart Valve Prosthesis*
  • Hemodynamics
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Postoperative Complications
  • Risk Assessment
  • Risk Factors
  • Statistics, Nonparametric
  • Stroke / etiology
  • Time Factors
  • Treatment Outcome