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. |
