Two-Year Outcomes for Patients With Severe Symptomatic Aortic Stenosis Treated With Transcatheter Aortic Valve Implantation

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• 作者：Pablo Codner ; MD^a ; Abid Assali ; MD^a ; Danny Dvir ; MD^a ; Hana Vaknin-Assa ; MD^a ; Eyal Porat ; MD^b ; Yaron Shapira ; MD^a ; Marina Kupershmidt^a ; Tamir Bental ; MD^a ; Alexander Battler ; MD^a ; Alexander Sagie ; MD^a ; Ran Kornowski ; MD^a ; ^{ran.kornowski@gmail.com}
• 刊名：The American Journal of Cardiology
• 出版年：2013
• 出版时间：1 May, 2013
• 年：2013
• 卷：111
• 期：9
• 页码：1330-1336
• 全文大小：386 K

文摘

Transcatheter aortic valve implantation (TAVI) is an emerging technique for the treatment of severe symptomatic aortic stenosis. Little has been reported about the use of different devices and multiple catheter-based options and anesthetic techniques in the same institution. We report the long-term clinical experience in treating patients with severe symptomatic aortic stenosis using TAVI. We analyzed the outcomes of 153 TAVI-treated patients who were followed for ¡Ü2 years. All patients were at very high risk of surgical valve replacement. The Medtronic-CoreValve device was used in 59.5 % and the Edwards-SAPIEN device in 40.5 % of the patients. The primary end point was death from any cause during follow-up. The mean ¡À SD patient age was 81.1 ¡À 6 years, and 62 % of the patients were women. The procedural success rate was 97.4 % . At 30 days of follow-up, the all-cause mortality was 3.9 % . Two-year follow-up data were obtained for 108 patients, with 85.5 % survival of treated patients. The 30-day stroke rate was 3.9 % . No significant differences in mortality were found when angioplasty was performed before or during TAVI compared with TAVI alone. Multivariate analysis showed that increased baseline creatinine (hazard ratio 1.55, 95 % confidence interval 1.01 to 2.42, p?= 0.049) and increased logistic European System for Cardiac Operative Risk Evaluation score (hazard ratio 1.03, 95 % confidence interval 1.01 to 1.06, p?= 0.048) predicted all-cause mortality. In conclusion, the clinical outcome of TAVI is favorable. The use of both procedural devices and multiple techniques in the same institution is feasible and potentially desirable.