In this multicenter, observational prospective study, carried out in 3 hospitals, percutaneous aortic valves were implanted in 449 patients with severely calcified aortic stenosis. Of these, 36 (8 % ) met the criteria for porcelain aorta. The primary end-point was death from any cause at 2 years.
Patients with porcelain aorta more frequently had extracardiac vascular disease (11 [30.6 % ] vs 49 [11.9 % ]; P=.002), prior coronary revascularization (15 [41.7 % ] vs 98 [23.7 % ]; P=.017), and dyslipidemia (26 [72.2 % ] vs 186 [45 % ]; P=.02). In these patients, there was greater use of general anesthesia (15 [41.7 % ] vs 111 [16.9 % ]; P=.058) and axillary access (9 [25 % ] vs 34 [8.2 % ]; P=.004). The success rate of the procedure (94.4 vs 97.3 % ; P=.28) and the incidence of complications (7 [19.4 % ] vs 48 [11.6 % ]; P=.20) were similar in both groups. There were no statistically significant differences in the primary end point at 24 months of follow-up (8 [22.2 % ] vs 66 [16 % ]; P=.33). The only predictive variable for the primary end point was the presence of complications during implantation (hazard ratio=2.6; 95 % confidence interval, 1.5-4.5; P=.001).
In patients with aortic stenosis and porcelain aorta unsuitable for surgery, percutaneous implantation of the CoreValve? self-expanding valve prosthesis is safe and feasible.