Transcatheter aortic valve implantation: Single center experience with mid-term follow-up

Background Transcatheter aortic-valve implantation (TAVI) is an emerging intervention for the treatment of high-risk patients with severe aortic stenosis and coexisting illnesses. Methods Between August 2009 and May 2012, we have conducted a retrospective study underwent a balloon expandable transcatheter xenograft (Edwards SAPIEN®) and evaluated the intermediate-term all cause mortality. Average STS and EuroSCORE II predicted risk for mortality was 18.4 ± 8.9% and 7.6 ± 5.5%, respectively. The end points included feasibility, safety, efficacy, and durability. Results A total of 27 consecutive patients underwent TAVI. Nine (33.3%) patients among them had it through the trans-apical approach. The mean age was 76 ± 8 years; 41% of the patients were females. There was 100% successful implantation. Hospital and one-year mortality were 2 (7.4%) and 4 (14.8%), respectively. At 1 year, the incidence of stroke was 1 (3.7%), infection 6 (22%), AV block 2 (7.4%), severe bleeding 2 (7.4%), vascular complication (14.8%), and the incidence of periprosthetic aortic regurgitation ( p  = 0.001), and of aortic valve area (AVA) with mean 0.4 ± 01cm2 ranging from 0.2 to 0.9 cm2 pre-and 1 ± 0.3 cm 2 ranging from 1 to1.9 cm 2 post-TAVI ( p  = 0.0001). The aortic pressure gradients have improved significantly from 45 ± 11 mm Hg pre-to 8.5± 5.5 mm Hg post-implantation ( p  = 0.0001). For all patients the average length of follow-up by echocardiography was 346 days and was 100% completed. Conclusions TAVI has provided good results in the initial 27 patients. However, The use of transcatheter aortic valve implantation should be restricted to the inoperable high-risk patients.