Document Detail


Transcatheter aortic valve implantation in patients with bicuspid aortic valve stenosis.
MedLine Citation:
PMID:  21087746     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We evaluated transcatheter aortic valve implantation (TAVI) in high-risk patients with bicuspid aortic valve (BAV) stenosis.
BACKGROUND: TAVI shows promise in the treatment of severe stenosis of triscupid aortic valves, especially in high-risk patients. However, BAV stenosis has been considered a contraindication to TAVI.
METHODS: Eleven patients (age 52 to 90 years) with symptomatic severe BAV stenosis underwent TAVI at 3 Canadian tertiary hospitals between May 2006 and April 2010. All patients were considered high risk for surgical aortic valve replacement. Edwards-SAPIEN transcatheter heart valves (Edwards Lifesciences, Inc., Irvine, California) were used. Transfemoral or transapical access was selected, depending on the adequacy of femoral access.
RESULTS: Access was transfemoral in 7 patients and transapical in 4 patients. There were no intraprocedural complications. Significant symptomatic and hemodynamic improvement was observed in 10 of 11 patients. Baseline aortic valve area of 0.65 ± 0.17 cm(2) and mean transaortic pressure gradient of 41 ± 22.4 mm Hg were improved to 1.45 ± 0.3 cm(2) and 13.4 ± 5.7 mm Hg, respectively. Two patients had moderate perivalvular leaks. At the 30-day follow-up there were 2 deaths due to multisystem failure in 2 transapical patients. In 1 patient an undersized, suboptimally positioned, unstable valve required late conversion to open surgery.
CONCLUSIONS: TAVI in selected high-risk patients with severe BAV stenosis can be successfully performed with acceptable clinical outcomes but will require further evaluation.
Authors:
Namal Wijesinghe; Jian Ye; Josep Rodés-Cabau; Anson Cheung; James L Velianou; Madhu K Natarajan; Eric Dumont; Fabian Nietlispach; Ronen Gurvitch; David A Wood; Edgar Tay; John G Webb
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  JACC. Cardiovascular interventions     Volume:  3     ISSN:  1876-7605     ISO Abbreviation:  JACC Cardiovasc Interv     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-22     Completed Date:  2011-03-04     Revised Date:  2012-08-29    
Medline Journal Info:
Nlm Unique ID:  101467004     Medline TA:  JACC Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1122-5     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Affiliation:
St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Aortic Valve / abnormalities*,  physiopathology,  ultrasonography
Aortic Valve Stenosis / physiopathology,  therapy*,  ultrasonography
Canada
Echocardiography, Transesophageal
Female
Femoral Artery
Heart Catheterization* / instrumentation
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation / instrumentation,  methods*
Hemodynamics
Humans
Male
Middle Aged
Prosthesis Design
Severity of Illness Index
Thoracotomy
Time Factors
Treatment Outcome

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


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