201 Transcatheter aortic valve implantation with the Edwards valve prosthesis in patients with contra-indication to surgery but low (<20%) logistic Euroscore: results of the Rouen registry

Objective Transcatheter aortic valve implantation (TAVI) has become a therapeutic option for high-risk or nonoperable patients with severe symptomatic aortic valve stenosis. The best known and most frequently implanted prostheses are the CoreValve and SAPIEN prostheses. We report our experiences and analyze the results of our TAVI program. Methods A total of 357 patients underwent transfemoral (TF) and transapical (TA) TAVI in our center between January 2008 and October 2012. The procedure was performed in 190 patients with CoreValve, in 155 patients with SAPIEN, and in 12 patients with ACURATE TA prostheses. Transfemoral access was used in 190 patients. In 167 patients, TA access was used. The mean age was 80.2 ± 6.4 years. All patients were nonoperable or had a high risk for a conventional aortic valve replacement. The mean logistic EuroSCORE I was 25.92 ± 14.51%. The TF/CoreValve (190 patients) and TA/SAPIEN (155 patients) groups showed significant difference in the patients’ mean age (81.7 ± 6.3 years vs. 79.5 ± 6.6 years, P = 0.002) and in mean logistic EuroSCORE I (22.16 ± 13.05% vs. 31.04 ± 16.40, P < 0.001). Results The overall 30-day mortality (357 patients) was 9.80% (TF, 8.42%; TA, 11.37%); overall 1-year mortality (275 patients), 21.45% (TF, 23.74%; TA, 19.12%); overall 2-year mortality (199 patients), 29.15% (TF, 35.96%; TA, 23.64%); overall 3-year mortality (133 patients), 37.59% (TF, 43.86%; TA, 32.89%); and overall 4-year mortality (38 patients), 39.47% (TF, 45%; TA, 33.33%). The rate of pacemaker implantation after TAVI was significantly higher in the CoreValve group than in the SAPIEN group: 44.74% (85/190 patients) versus 6.45% (10/155 patients), P < 0.001. Stroke rate was higher in the TF-CoreValve group than in the TA-SAPIEN group: 4.21% versus 0.64%, P = 0.045. Conclusions Outcomes after TAVI were, in our population of nonoperable and high-risk patients, encouraging. The differences in midterm outcomes between the TF-CoreValve TAVI and the TA-SAPIEN TAVI were not significant.

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Predictive reliability of logistic EuroSCORE II in patients undergoing transcatheter aortic valve implantation: Assessment and comparison to classic systems of preoperative risk stratification

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0032-1332254 ◽

2013 ◽

Vol 61 (S 01) ◽

Author(s):

L Conradi ◽

M Silaschi ◽

R Schnabel ◽

M Seiffert ◽

G Schön ◽

...

Keyword(s):

Aortic Valve ◽

Risk Stratification ◽

Transcatheter Aortic Valve Implantation ◽

Preoperative Risk ◽

Logistic Euroscore ◽

Transcatheter Aortic Valve ◽

Preoperative Risk Stratification ◽

Aortic Valve Implantation ◽

Valve Implantation

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Improvement in Risk Stratification in Transcatheter Aortic Valve Implantation Using a Combination of the Tumor Marker CA125 and the Logistic EuroSCORE

Revista Española de Cardiología (English Edition) ◽

10.1016/j.rec.2016.08.004 ◽

2017 ◽

Vol 70 (3) ◽

pp. 186-193 ◽

Cited By ~ 1

Author(s):

Oliver Husser ◽

Julio Núñez ◽

Christof Burgdorf ◽

Andreas Holzamer ◽

Christian Templin ◽

...

Keyword(s):

Aortic Valve ◽

Risk Stratification ◽

Tumor Marker ◽

Transcatheter Aortic Valve Implantation ◽

Logistic Euroscore ◽

Transcatheter Aortic Valve ◽

Aortic Valve Implantation ◽

Valve Implantation

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Antithrombotic treatment in patients undergoing transcatheter aortic valve implantation (TAVI)

Thrombosis and Haemostasis ◽

10.1160/th14-10-0821 ◽

2015 ◽

Vol 113 (04) ◽

pp. 674-685 ◽

Cited By ~ 21

Author(s):

Vincent J. Nijenhuis ◽

Naoual Bennaghmouch ◽

Jan-Peter van Kuijk ◽

Davide Capodanno ◽

Jurriën M. ten Berg

Keyword(s):

Aortic Valve ◽

Transcatheter Aortic Valve Implantation ◽

Bleeding Complications ◽

Valve Prosthesis ◽

Surgical Aortic Valve Replacement ◽

Transcatheter Aortic Valve ◽

Mitral Valve Prosthesis ◽

Ischemic Complications ◽

Aortic Valve Implantation ◽

Valve Implantation

SummaryTranscatheter aortic valve implantation (TAVI) is an established treatment option for symptomatic patients with severe aortic valvular disease who are not suitable for conventional surgical aortic valve replacement. Despite improving experience and techniques, ischaemic and bleeding complications after TAVI remain prevalent and impair survival in this generally old and comorbid-rich population. Due to changing aetiology of complications over time, antiplatelet and anticoagulant therapy after TAVI should be carefully balanced. Empirically, a dual antiplatelet strategy is generally used after TAVI for patients without an indication for oral anticoagulation (OAC; e. g. atrial fibrillation, mechanical mitral valve prosthesis), including aspirin and a thienopyridine. For patients on OAC, a combination of OAC and aspirin or thienopyridine is generally used. This review shows that current registries are unfit to directly compare antithrombotic regimens. Small exploring studies suggest that additional clopidogrel after TAVI only affects bleeding and not ischemic complications. However, these studies are lack in quality in terms of Cochrane criteria. Currently, three randomised controlled trials are recruiting to gather more knowledge about the effects of clopidogrel after TAVI.

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Features of echocardiographic assessment on transcatheter aortic valve implantation multiple stages

Ukrainian Journal of Cardiology ◽

10.31928/1608-635x-2021.1.4351 ◽

2021 ◽

Vol 28 (1) ◽

pp. 43-51

Author(s):

G. I. Yemets ◽

O. V. Telehuzova ◽

G. B. Mankovsky ◽

A. V. Maksymenko ◽

Ye. Yu. Marushko ◽

...

Keyword(s):

Aortic Valve ◽

Transcatheter Aortic Valve Implantation ◽

Severe Aortic Stenosis ◽

Full Range ◽

Valve Prosthesis ◽

Novel Device ◽

Transcatheter Aortic Valve ◽

Echocardiographic Parameters ◽

Aortic Valve Implantation ◽

Valve Implantation

The aim – to systematize information on key features of echocardiographic evaluation of transcatheter aortic valve implantation (TAVI) procedure stages and their effectiveness in cardiac surgery, in patients with severe aortic valve stenosis.Materials and methods. We initiated a single-center clinical study to evaluate the XPand device and initial analysis of the primary results was performed. Patients met the inclusion criteria underwent a full range of examinations and TAVI procedures using the XPand device. The key parameters for echocardiographic examination in TAVI, which influence the formation of further procedure strategy, have been determined for the cardiac surgeon.Results and discussion. Based on the determined echocardiographic parameters, we obtained the primary outcomes of TAVI XPand in patients (n=7), the result of implantation was good. Minimal paravalvular insufficiency absence was found in 71.5 % of patients and minimal insufficiency in 14,5 %. In one patient to moderate insufficiency was observed. There was a statistically significant improvement in the ejection fraction (p<0.05) and a decrease in the mean gradient at the aortic valve (p<0.01).Conclusions. Echocardiographic parameters at all TAVI stages in patients over 75 years allow to control the implementation of the procedure and to improve the immediate post procedural outcome. The first experience of using the novel device for transcatheter implantation of the XPand aortic valve prosthesis confirms its effectiveness and safety in elderly patients with severe aortic stenosis.

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