Two years’ experience in transapical aortic valve implantation

الملخص EN

Objectives : To describe the results of transcatheter aortic valve implantation in high-risk patients with aortic stenosis using the transapical approach.

Methods : From September 2006 till March 2010, with the mean follow up of 2 years, forty-five patients with severe symptomatic aortic stenosis were treated with transapical - transcatheter aortic valve implantation using the Edwards SAPIEN valve, because of high surgical risk or contraindications to surgery.

Mean age was 81 ± 10 years, mostly in New York Heart Association classes III/IV, the predicted surgical mortality was (12 ± 16%) using the European System for Cardiac Risk Evaluation (Euro SCORE) ; or the Society of Thoracic Surgeons Predicted Risk Of Mortality (STS-PROM) more than 10%.

Results : Successful implantation was achieved in all patients with satisfactory postoperative gradients.

In-hospital mortality was 18%.

Stroke was not observed in any patient.

Conclusions : Transcatheter aortic valve implantation provides a privileged and direct approach to the aortic valve and allows antegrade manipulation of the instruments.

There are no limits on the size of introducing system and it is not affected by peripheral vessel tortuosity or disease.