| Transapical Aortic Valve Implantation: Experiences and Survival Analysis up to Three Years. | |
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MedLine Citation:
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PMID: 23046081 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Abstract Background: We determined our 30-day results after transapical aortic valve implantation (TA-AVI) according to Valve Academic Research Consortium criteria, analyzed midterm outcome, and summarize our institutional learning experience. Methods: From February 2008 to July 2011, 150 high-risk patients underwent TA-AVI. Endpoints of this retrospective analysis were safety as indicated by morbidity and 30-day mortality and midterm survival with a follow-up period up to 3.4 years (mean follow-up 14.1 months). In addition we analyzed our institutional learning curve by comparing the outcome of our first 50 patients (group 1) to the following 100 patients (group 2). Results: Procedural success was 98% (147 patients). All-cause and cardiovascular cause 30-day mortality was 11.3% (n = 17) and 7.3% (n = 11), respectively. The cumulative survival rates were 78.7% at one year, 62.8% at two years, and 50.8% at three years. As compared to group 1, there was a significantly reduced incidence of relevant bleeding complications (0% vs. 14%[n = 7]; p < 0.001) and a reduced incidence of acute kidney injury (35%[n = 35] versus 56% (n = 28); p < 0.05) in group 2, resulting in a combined safety endpoint at 30 days of 22% in group 2 versus 40% in group 1 (p < 0.05). One-year mortality (group 2, n = 20 [20%] versus group 1, n = 10 [20%]; p = 1) and midterm survival (p = 0.998; Hazard ratio 1.001; 95% CI 0.5141 to 1.949) did not differ significantly. Conclusions: Although the incidence of technical complications decreased significantly over time, 30-day and midterm mortality were unaltered, most likely due to patients' comorbidities. The development of more accurate risk scores may improve future outcome. (J Card Surg 2012;**:1-9). |
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Authors:
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Maximilian Scherner; Navid Madershahian; Stephan Rosenkranz; Ingo Slottosch; Elmar Kuhn; Georg Langebartels; Antje Deppe; Jens Wippermann; Yeong-Hoon Choi; Justus T Strauch; Thorsten Wahlers |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-10-10 |
Journal Detail:
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Title: Journal of cardiac surgery Volume: - ISSN: 1540-8191 ISO Abbreviation: J Card Surg Publication Date: 2012 Oct |
Date Detail:
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Created Date: 2012-10-10 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8908809 Medline TA: J Card Surg Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© 2012 Wiley Periodicals, Inc. |
Affiliation:
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Department of Cardiothoracic Surgery Department of Cardiology, University Hospital of Cologne, Cologne, Germany. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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