Mid-term results of 150 TAVI comparing apical versus femoral approaches
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RESEARCH ARTICLE
Open Access
Mid-term results of 150 TAVI comparing apical versus femoral approaches Alain Rougé2,3*, Olivier Huttin2,3, Rumas Aslam2,3, Thibaud Vaugrenard2,3, Thomas Jouve4, Michael Angioi2,3 and Pablo Maureira1,3
Abstract Background: Transcatheter aortic-valve implantation (TAVI) is a new therapeutic choice for treating aortic stenosis in patients considered high risk for surgery. This blooming therapeutic technique still requires evaluation of medium and long term outcome. Method: We hereby report our results of the first 150 consecutive patients to receive TAVI implants in our population recruited from July 2009 to March 2013 in a retrospective and monocentric study. We analyzed long term morbidity and mortality criteria. We compared the apical and femoral approach results and researched predictors of cardiac mortality. Results: The mean monitoring period was 387.62 days, mean Euroscore was 21.8, and mean Society of Thoracic Surgeons (STS) risk score was 9.2. The success rate for the procedure was 94.6 %. A total of 39 patients died. The mortality rates at the immediate perioperative point, 30 days, 1 year, and 2 years, were 4 %, 11.3 %, 22.7 %, and 26 %, respectively. As regards complications, there were 10 hemodynamic complications (6.6 %) and 20 vascular (13.3 %), 11 cardiac tamponades (7.4 %), eight mechanical (5.3 %), ten major hemorrhagic (6.7 %), 14 pulmonary (9.3 %), and 18 infectious complications (12 %). When comparing the rates of reported complications in terms of different approaches, we observed significantly more hemodynamic complications in the apical group (p = 0.049). Pulmonary complications were also significantly more common in cases of apical approach (p = 0.029). The majority of the patients reported clear functional improvement throughout their follow-up. Conclusion: The results of the first 150 patients to receive the implant at the Nancy University Teaching Hospital (CHU Nancy) were consistent with findings in the literature. TAVI proved a credible and effective alternative to surgical valve replacement for patients at high risk during surgery. Keywords: TAVI: Transcatheter aortic-valve implantation, Aortic stenosis, VARC: Valve Academic Research Consortium
Background Calcified aortic stenosis is the most common type of valvular heart disease found among adults in Western industrialized countries [1]. The etiology for this disease is mainly degenerative, therefore those affected are primarily of an advanced age. Observational studies demonstrate that its prevalence increases significantly with age, from 1.5 % for the 64–74-year age group to 4.8 % for those aged 75 and over [1]. Since the first * Correspondence: [email protected] 2 Service de Cardiologie, CHU de Nancy, Hôpital Brabois, rue du Morvan, F-54511 Vandoeuvre-les-Nancy, France 3 Université de Lorraine, Nancy, France Full list of author information is available at the end of the article
percutaneous transcatheter implantation of an aortic valve prosthesis [2], transcatheter aortic-valve implantation (TA
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