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Transcatheter-Based Aortic Valve Implantations at Midterm: What Happened to Our Initial Patients?
MedLine Citation:
PMID:  22776084     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: This report analyzes a single institution's results with transapical aortic valve implantation (TAVI) from an initial series of patients over 5 years. METHODS: A series of 100 patients underwent TAVI at our institution between January 2005 and December 2008. The mean patient age was 85 ± 6 years. All patients had a high perioperative risk for aortic valve replacement (mean logistic EuroSCORE of 36% ± 12%; Society of Thoracic Surgeons [STS] score 16% ± 3%). Clinical and echocardiographic variables were entered prospectively into a database. Late follow-up for survival, clinical outcomes including the New York Heart (NYHA) Association functional class, and echocardiographic assessment was 100% complete. RESULTS: After a mean follow-up of 3.8 ± 2 years, overall mortality was 13% (n = 13/100), 30-day mortality was 8% (8/100), and late mortality was 5% (5/100). There were 2 perioperative repeated thoracotomies for bleeding, 2 intraoperative conversions, 1 prosthesis embolization, and 2 cases of impairment of coronary arteries. The causes of late mortality were cardiac failure (n = 2), respiratory failure (n = 1), renal failure (n = 1), and cancer (n = 1). At late follow-up there were no cases of endocarditis or stroke in any of the patients. None of the valves showed structural valve degeneration. NYHA functional class improved from 3.4 ± 0.4 before operation to 1.9 ± 0.5 at late follow-up (p = 0.02). Only 4 patients did not improve in functional class. CONCLUSIONS: Midterm outcomes after TAVI in high-risk patients at our institution show an improvement in functional capacity, with a good survival rate. Valve degeneration is not an issue at midterm follow-up.
Authors:
Mirko Doss; Estelle Bianca Buhr; Sven Martens; Anton Moritz; Andreas Zierer
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-7
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  -     ISSN:  1552-6259     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Affiliation:
Division of Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University, Frankfurt/Main, Germany.
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