scholarly journals Introducing transcatheter aortic valve implantation with a new generation prosthesis: Institutional learning curve and effects on acute outcomes

2016 ◽  
Vol 25 (2) ◽  
pp. 106-115 ◽  
Author(s):  
G. D’Ancona ◽  
H. U. Agma ◽  
S. Kische ◽  
G. El-Achkar ◽  
M. Dißmann ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Learning Curve ◽  
Transcatheter Aortic Valve Implantation ◽  
Transcatheter Aortic Valve ◽  
Institutional Learning ◽  
Aortic Valve Implantation ◽  
Valve Implantation ◽  
New Generation

scholarly journals Transaortic Transcatheter Aortic Valve Implantation: Learning Curve, Perioperative, and Midterm Follow-Up Results of a Single Center

2019 ◽  
Vol 22 (2) ◽  
pp. E134-E139 ◽  
Author(s):  
Giuseppe D’Ancona ◽  
Huesyin Ince ◽  
Christoph Raspé ◽  
Alper Öner ◽  
Evren Caglayan ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Learning Curve ◽  
Contrast Agent ◽  
Transcatheter Aortic Valve Implantation ◽  
Aortic Insufficiency ◽  
Transcatheter Aortic Valve ◽  
Institutional Experience ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Background: We present our initial institutional experience with transaortic (TAo) transcatheter aortic valve implantation (TAVI) using a self-expanding aortic bioprosthesis. Methods: A total of 106 patients underwent TAo TAVI with Medtronic CoreValve through a small partial upper sternotomy. We focus our analysis on the overall perioperative results, procedural learning curve (first 30 patients), and midterm follow-up outcomes. Results: VARC-2 device success was achieved in 95 patients (89%), and there were no intraoperative deaths. Nine patients (8.4%) required a second valve and conversion to standard surgery was required in 2 patients (1.8%). The final aortic insufficiency was grade 0 in 65 patients (62%) and grade 1 in 39 (37%). Although patients treated in the TAo TAVI learning phase required a significantly longer radiation time and contrast agent use, device success (93.4% versus 88.2%; P = .7) and prostheses hemodynamics were similar. All-cause mortality at 30 days was 12% (13/106). At a median follow-up of 392 days (IQR: 216-494 days) estimated overall 1-year survival was 72%. No significant differences were reported in terms of 30-day and 1-year observed mortality, and estimated 1-year survival in the learning and later phase of TAo TAVI. Conclusion: TAo TAVI can be performed safely even in the very early phase of the learning curve. Although satisfactory results can be achieved from the beginning, a significant reduction in contrast agent use and radiological exposure are expected as the technique is mastered. Good hemodynamics have been documented and should be further improved with modifications achieved in the TAVI self-expandable valves technology.

scholarly journals Alternate Access for TAVI: Stay Clear of the Chest

2018 ◽  
Vol 13 (3) ◽  
pp. 145 ◽  
Author(s):  
Pavel Overtchouk ◽  
Thomas Modine ◽  
◽  
Keyword(s):  
Aortic Valve ◽  
Learning Curve ◽  
Transcatheter Aortic Valve Implantation ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
Poor Outcomes ◽  
Valve Implantation ◽  
Transapical Access ◽  
Experimental Stage ◽  
Existing Data

Transcatheter aortic valve implantation (TAVI) is currently performed through an alternative access in 15 % of patients. The transapical access is progressively being abandoned as a result of its invasiveness and poor outcomes. Existing data does not allow TAVI operators to favour one access over another — between transcarotid, trans-subclavian and transaortic — because all have specific strengths and weaknesses. The percutaneous trans-subclavian access might become the main surgery-free alternative access, although further research is needed regarding its safety. Moreover, the difficult learning curve might compromise its adoption. The transcaval access is at an experimental stage and requires the development of dedicated cavo-aortic crossing techniques and closure devices.

Impact of Predilation Before Transcatheter Aortic Valve Implantation with New-Generation Devices

2019 ◽  
Vol 20 (12) ◽  
pp. 1096-1099 ◽  
Author(s):  
Arturo Giordano ◽  
Nicola Corcione ◽  
Paolo Ferraro ◽  
Alberto Morello ◽  
Sirio Conte ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Implantation ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
Valve Implantation ◽  
New Generation
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