scholarly journals 540 Progressive temporal reduction of complications after TAVI

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Giuseppe Panuccio ◽  
Iolanda Aquila ◽  
Sabato Sorrentino ◽  
Giuseppina Mascaro ◽  
Annalisa Mongiardo ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Severe Aortic Stenosis ◽  
Vascular Complication ◽  
Assessment System ◽  
Valve Prosthesis ◽  
Continuous Growth ◽  
P Values ◽  
Number Of Patients ◽  
Interval Value

Abstract Aims The TAVI registry represents a single-centre observational retrospective study that consecutively collected symptomatic patients with severe aortic stenosis between September 2009 and February 2021 at the Magna Graecia University (Catanzaro, Italy). Our aim was to evaluate the rate of complications which can occur after Transcatheter aortic valve replacement (TAVR) and its possible predictors. Methods We included a total of 346 consecutive patients, admitted to our institution between September 2009 and February 2021. Inclusion criteria were: severe aortic stenosis in high-risk patients unsuitable for surgery after cardiac team consent, valve anatomy adjusted according to device instructions for use, life expectancy> 1 year. Clinical, echocardiographic and procedural data were collected and reported in an electronic database. Surgical risk was prospectively assessed using the European Cardiac Operational Risk Assessment System (EuroSCORE II, https://www.euros core.org/calc.html). The mean age of the population was 80.3 ± 5.4 years; 144 patients (41.6%) were male. The average EuroSCORE II was 6.3 ± 5.7. All reported P-values are two-sided and P-values <0.05 were considered significant. STATA (StataCorp, USA) was used for data analysis. Results Out of the total population analysed, the number of patients who underwent a vascular complication was 23 or 6.6%. Female sex was an independent predictor of vascular complication (P 0.015) regardless of the presence of peripheral vascular disease (OR 3.73; 95% CI 1.20–11.5), while no correlation was found with BSA. The number of patients experiencing severe bleeding and/or need for transfusion was 85 or 24.6% of the total. Mean baseline haemoglobin values were 12.1 g/dL ± 1.7 with lower mean values reported during hospitalization of 9.2 g/dL ± 1.4 (P <0.001), while predicted values at discharge were 9.8 g/dL ± 1.2. The pre and post procedural PR interval value was 171.1 ± 33.6 ms vs. 193.3 ± 35.7 ms (P <0.001) (Figure 2). The pre-procedural QRS interval value was 95.0 ± 21.7, the post-procedural mean value was 115.4 ± 26.5 (P <0.001). The number of patients with QRS> 120 ms after the procedure was 92 (26.5%). Out of the total number of patients analysed, the number of subjects who required PM implantation was 77 patients, i.e. 22.3% of the total. Of these, 25 patients (32.4%), Evolut R 45 patients (58.6%) and Sapien 7 patients (9.0%) had received implants. The need for pacemaker implantation did not affect the average length of stay (P 0.5). Conclusions Since its advent, the transfemoral aortic valve prosthesis implant has experienced impressive and continuous growth, radically revolutionizing the treatment of symptomatic severe aortic stenosis. Furthermore, the clear improvement of the procedural safety and efficacy profiles, due on the one hand to the technological evolution of the devices, of the introduction and release systems and of the experience of the operators, has reduced the number of complications related to the implant and improved the management of the same.

scholarly journals Percutaneous implantation of self-expandable aortic valve in high risk patients with severe aortic stenosis: The first experiences in Serbia

2016 ◽  
Vol 73 (2) ◽  
pp. 192-197 ◽  
Author(s):  
Milan Nedeljkovic ◽  
Branko Beleslin ◽  
Milorad Tesic ◽  
Vladan Vukcevic ◽  
Goran Stankovic ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Severe Aortic Stenosis ◽  
Vascular Complication ◽  
Functional Improvement ◽  
Heart Team ◽  
Initial Experience ◽  
Surgical Risk ◽  
Number Of Patients ◽  
High Surgical Risk

Background/Aim. Aortic stenosis (AS) is the most common valvular heart disease in elderly people, with rather poor prognosis in symptomatic patients. Surgical valve replacement is the therapy of choice, but a significant number of patients cannot undergo surgical procedure. We presented initial experience of transcatheter aortic valve implantation (TAVI) performed in Catheterization Laboratory of the Clinic for Cardiology, Clinical Center of Serbia. Methods. The procedures were performed in 5 patients (mean age 76 ? 6 years, 2 males, 3 female) with severe and symptomatic AS with contraindication to surgery or high surgical risk. The decision to perform TAVI was made by the heart team. Pre-procedure screening included detailed clinical and echocardiographic evaluation, coronary angiography and computed tomography scan. In all the patients we implanted a self-expandable aortic valve (Core Valve, Medtronic, USA). Six months follow-up was available for all the patients. Results. All interventions were successfully performed without significant periprocedural complications. Immediate hemodynamic improvement was obtained in all the patients (peak gradient 94.2 ? 27.6 to 17.6 ? 5.2 mmHg, p < 0.001, mean pressure gradient 52.8 ? 14.5 to 8.0 ? 2.1 mmHg, p < 0.001). None of the patients developed heart block, stroke, vascular complication or significant aortic regurgitation. After 6 months, the survival was 100% with New York Heart Association (NYHA) functional improvement in all the patients. Conclusion. This successful initial experience provides a solid basis to treat larger number of patients with symptomatic AS and high surgical risk who are left untreated.

The impact of percutaneous implantation of aortic valve prosthesis in the treatment of severe aortic stenosis

2011 ◽  
Vol 149 (1) ◽  
pp. 128-130 ◽  
Author(s):  
Juan Caballero-Borrego ◽  
Juan Horacio Alonso-Briales ◽  
Antonio Muñoz-García ◽  
Antonio Domínguez-Franco ◽  
José María Melero-Tejedor ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Severe Aortic Stenosis ◽  
Valve Prosthesis ◽  
Aortic Valve Prosthesis ◽  
The Impact

scholarly journals First experience of using NVT Allegra system for transcatheter implantation of aortic valve and prospects for routine interventions on aortic valve in Ukraine

2020 ◽  
Vol 27 (2) ◽  
pp. 57-64
Author(s):  
G. B. Mankovsky ◽  
Ye. Yu. Marushko ◽  
S. O. Kuzmenko ◽  
G. I. Yemets ◽  
I. M. Yemets
Keyword(s):  
Blood Flow ◽  
Aortic Valve ◽  
Aortic Stenosis ◽  
Severe Aortic Stenosis ◽  
Valve Prosthesis ◽  
Surgical Risk ◽  
High Surgical Risk ◽  
Aortic Valve Prosthesis ◽  
Transcatheter Implantation ◽  
Flow Gradients

The aim – to present the first experience in Ukraine of using the NVT Allegra device for the procedure of transcatheter implantation of the aortic valve prosthesis to patients with high surgical risk with severe aortic stenosis. Materials and methods. The presented clinical cases included two patients of age 90 and 80 years with severe aortic stenosis, mean transaortic blood flow gradients of 32 and 76 mm Hg and aortic valve areas of 0.4 and 0.6 cm2, respectively. Both patients were recognized as high surgical risk patients. Results and discussion. Both patients underwent transcatheter implantation of the aortic valve prosthesis through transfemoral access. After implantation, the average gradients of the transaortic blood flow were 13 and 8 mm Hg respectively. Residual paravalvular insufficiency was mild in both cases. Second patient was implanted permanent pacemaker due to persistent complete AV block. Conclusions. The NVT Allegra system for transcatheter implantation of the aortic valve prosthesis is a third generation device that enables successful and safe intervention of the aortic valve.

scholarly journals The Distinguish Method of Severe Aortic Stenosis Treatment Geriatric High Mortality Risk Patients

Kardiologiia ◽  
2020 ◽  
Vol 60 (4) ◽  
pp. 43-47
Author(s):  
E. V. Kryukov ◽  
D. L. Kranin ◽  
A. V. Gajdukov ◽  
A. Yu. Fedorov ◽  
D. A. Nazarov ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Severe Aortic Stenosis ◽  
Postoperative Mortality ◽  
Surgical Care ◽  
Valve Prosthesis ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Prosthesis ◽  
Risk Patients ◽  
Valve Pathology

Aim To improve quality of treatment for senile patients with pronounced aortic stenosis (AS).Material and methods Aortic valve stenosis (AS) is the most common valve pathology in cardiosurgical patients. Surgical correction of aortic valve (AV) stenosis accounts for 10 to 22 % of open-heart operations. 125 patients with pronounced AS were treated in the N. N. Burdenko Main Military Clinical Hospital between 2010 and 2017. This study was based on the implementation of new, minimally invasive methods in our clinic in 2013: balloon aortic valvuloplasty (BAVP) of the aortic valve and transcatheter aortic valve prosthesis (TCAVP).Results In the group of patients receiving the drug therapy alone, the in-hospital mortality was 2 %. At the time of maximum follow-up duration (3 years), the survival rate was 50.5 %. In the group of patients who underwent the AV replacement with extracorporeal circulation, the 3 year postoperative mortality was 16.6 %. There was no 3 year mortality in the group of patients who underwent TCAVP. The short-term beneficial effect of BAVP was confirmed.Conclusion An algorithm was developed for medical care of patients older than 75 with pronounced AS; the place of BAVP in the step-by-step management of these patients was determined. Using the developed approach in the management of these patients provided a 32 % (p<0.05) increase in the number of cases of radical surgical care.

scholarly journals Transfemoral aortic valve implantation in severe aortic stenosis patients with prior mitral valve prosthesis

2015 ◽  
Vol 4 ◽  
pp. 304-311 ◽  
Author(s):  
Cenk Sari ◽  
Serdal Baştuğ ◽  
Hüseyin Ayhan ◽  
Hacı Ahmet Kasapkara ◽  
Tahir Durmaz ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Aortic Stenosis ◽  
Severe Aortic Stenosis ◽  
Valve Prosthesis ◽  
Mitral Valve Prosthesis ◽  
Aortic Valve Implantation ◽  
Valve Implantation

scholarly journals Failed TAVI in TAVI Implantation: TAVI Dislocation Followed by Ensuing Surgical Graft Resection

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Róbert Novotný ◽  
Jaroslav Hlubocký ◽  
Tomáš Kovárník ◽  
Petr Mitáš ◽  
Zuzana Hlubocka ◽  
...  
Keyword(s):  
Case Report ◽  
Aortic Valve ◽  
Aortic Stenosis ◽  
Endovascular Repair ◽  
Surgical Intervention ◽  
Severe Aortic Stenosis ◽  
Valve Prosthesis ◽  
Severe Aortic Regurgitation ◽  
Aortic Valve Prosthesis ◽  
Valve In Valve

We are presenting a case report of failed valve-in-valve treatment of severe aortic stenosis. A control ultrasonography after TAVI implantation revealed a severe aortic regurgitation of the graft which was subsequently unresolved with postimplantation dilatation. Second TAVI was implanted with cranial dislocation to the aortic root. Patient underwent a CT examination to clarify the TAVI in TAVI position. Patient underwent a surgical resection of TAVI with implantation of biological aortic valve prosthesis. In situations where TAVI treatment fails or is complicated beyond the possibility of endovascular repair, surgical intervention despite its higher risks is the preferred choice.

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