Document Detail


Transapical aortic valve implantation in 175 consecutive patients: excellent outcome in very high-risk patients.
MedLine Citation:
PMID:  20797496     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aim of this study was to evaluate the outcome of transapical aortic valve implantation in a single center with expanded procedural experience and to compare it with predicted risk for conventional aortic valve surgery. BACKGROUND: Transapical aortic valve implantation is a new approach for high-risk patients with severe aortic stenosis. There are only limited single-center experiences with very small numbers of patients. METHODS: Since April 2008, transapical aortic valve implantation was performed in 175 consecutive patients. The mean patient age was 79.8 +/- 9 years, with a range of 36 to 97 years. The mean Society of Thoracic Surgeons score was 23.5 +/- 19.4% (range 2.7% to 89.5%); 98.3% of patients were in New York Heart Association functional class III or IV. Ten patients were in cardiogenic shock. RESULTS: Technical success of the procedure was 100%. There was no conversion to conventional surgery. Cardiopulmonary bypass was used in 8 patients (6 elective, 2 emergency). The 30-day mortality was 5.1% for the entire group, 3.6% for all patients without cardiogenic shock, and 30% for the patients with cardiogenic shock. Survival at 1, 6, and 12 months was 94.9%, 85.5%, and 82.6%, respectively. CONCLUSIONS: The outcome of transapical aortic valve implantation was very favorable and already reproducible during the learning curve. The method has become de facto our institutional primary choice for treatment of high-risk patients with severe aortic valve stenosis.
Authors:
Miralem Pasic; Axel Unbehaun; Stephan Dreysse; Thorsten Drews; Semih Buz; Marian Kukucka; Alexander Mladenow; Tom Gromann; Roland Hetzer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  56     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-27     Completed Date:  2010-09-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  813-20     Citation Subset:  AIM; IM    
Copyright Information:
Copyright (c) 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Affiliation:
Deutsches Herzzentrum Berlin, Berlin, Germany. pasic@dhzb.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Aortic Valve / surgery*
Aortic Valve Stenosis / mortality,  surgery*
Echocardiography
Female
Heart Valve Prosthesis Implantation / education,  methods*
Humans
Intraoperative Period
Male
Middle Aged
Postoperative Complications
Prosthesis Design
Shock, Cardiogenic / complications
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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