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Transcatheter aortic valve implantation: first results from a multi-centre real-world registry.
MedLine Citation:
PMID:  20864486     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
AIMS: Treatment of elderly symptomatic patients with severe aortic stenosis and co-morbidities is challenging. Transcatheter aortic valve interventions [balloon valvuloplasty and transcatheter aortic valve implantation (TAVI)] are evolving as alternative treatment options to surgical valve replacement. We report the first results of the prospective multi-centre German Transcatheter Aortic Valve Interventions-Registry.
METHODS AND RESULTS: Between January 2009 and December 2009, a total of 697 patients (81.4 ± 6.3 years, 44.2% males, and logistic EuroScore 20.5 ± 13.2%) underwent TAVI. Pre-operative aortic valve area was 0.6 ± 0.2 cm² with a mean transvalvular gradient of 48.7 ± 17.2 mmHg. Transcatheter aortic valve implantation was performed percutaneously in the majority of patients [666 (95.6%)]. Only 31 (4.4%) procedures were done surgically: 26 (3.7%) transapically and 5 (0.7%) transaortically. The Medtronic CoreValve™ prosthesis was used in 84.4%, whereas the Sapien Edwards™ prosthesis was used in the remaining cases. Technical success was achieved in 98.4% with a post-operative mean transaortic pressure gradient of 5.4 ± 6.2 mmHg. Any residual aortic regurgitation was observed in 72.4% of patients, with a significant aortic insufficiency (≥Grade III) in only 16 patients (2.3%). Complications included pericardial tamponade in 1.8% and stroke in 2.8% of patients. Permanent pacemaker implantation after TAVI became necessary in 39.3% of patients. In-hospital death rate was 8.2%, and the 30-day death rate 12.4%.
CONCLUSION: In this real-world registry of high-risk patients with aortic stenosis, TAVI had a high success rate and was associated with moderate in-hospital complications. However, careful patient selection and continued hospital selection seem crucial to maintain these results.
Authors:
Ralf Zahn; Ulrich Gerckens; Eberhard Grube; Axel Linke; Horst Sievert; Holger Eggebrecht; Rainer Hambrecht; Stefan Sack; Karl Eugen Hauptmann; Gert Richardt; Hans-Reiner Figulla; Jochen Senges;
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Publication Detail:
Type:  Journal Article     Date:  2010-09-23
Journal Detail:
Title:  European heart journal     Volume:  32     ISSN:  1522-9645     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  198-204     Citation Subset:  IM    
Affiliation:
Abteilung für Kardiologie, Herzzentrum Ludwigshafen, Bremserstrasse 79, Ludwigshafen, Germany. erzahn@aol.com
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Descriptor/Qualifier:
Investigator
Investigator/Affiliation:
U Gerckens / ; G Schuler / ; R Zahn / ; H Eggebrecht / ; H Sievert / ; K E Hauptmann / ; K H Kuck / ; R Hambrecht / ; G Richardt / ; G Nickenig / ; C H Naber / ; S Sack / ; H R Figulla / ; M Block / ; E Hoffmann / ; U Sechtem / ; H Gülker / ; G Riegger / ; H Mudra / ; F J Neumann / ; C Bode / ; J Brachmann /
Comments/Corrections
Comment In:
Eur Heart J. 2011 Jan;32(2):133-7   [PMID:  21131294 ]

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