Outcome of transcatheter aortic valve implantation in high risk patients with severe aortic stenosis

Abstract

Aim

To assess outcome of TAVI in high risk patients with severe symptomatic aortic stenosis.

Patients and methods

40 patients with symptomatic severe aortic stenosis and high risk underwent TAVI with implantation of either Sapien XT valve or Core Valve and followed for 6 months. Device success, cardiovascular mortality, myocardial infarction, stroke, life-threatening bleeding and vascular complications were defined according to Valve Academic Research Consortium definitions.

Results

The study included 40 patients, their mean age was 73.98 ± 8.40, procedural success was 97.5%. One patient need valve in valve due to moderately severe paravalvular leak. Total mortality was 7.5%, cardiovascular death occurred in 2.5% and non cardiovascular death occurred in 5%. Myocardial infarction occurred in one patient (2.5%), stroke occurred in 2 patients (5%), minor bleeding occurred in 6 patients (15%), major bleeding occurred in 3 patients (7.5%), minor vascular complications occurred in 4 patients (10%) while major vascular complications occurred in 3 patients (7.5%). Permanent pacemaker was inserted for 5 patients (12.5%), new onset AF occurred in 4 patients (10%). Re hospitalization was needed for 2 patients (5%) due to heart failure. After TAVI there were significant improvement in NYHA functional class (p < 0.001), mean LV ejection fraction and LV mass index (p < 0.001), mean aortic valve area, mean and peak pressure gradient (p < 0.001), severity of aortic and mitral regurgitation (p < 0.001). When comparing types of valves used, both were nearly comparable.

Conclusion

TAVI is a safe and effective procedure in selected high-risk patients with severe symptomatic aortic stenosis without significant difference between used valves.