scholarly journals Transcatheter aortic valve implantation at a high-volume center: the Bad Rothenfelde experience

2017 ◽  
Vol 4 ◽  
pp. 215-224 ◽  
Author(s):  
Marek Kowalski ◽  
Cornelia Deutsch ◽  
Steffen Hofmann ◽  
Norbert Franz ◽  
Michael Billion ◽  
...  
Open Heart ◽  
2020 ◽  
Vol 7 (1) ◽  
pp. e001233
Author(s):  
Iwan Harries ◽  
Jonathan R Weir-McCall ◽  
Michelle C Williams ◽  
James Shambrook ◽  
Giles Roditi ◽  
...  

ObjectiveThis cross-sectional observational study sought to describe variations in CT in the context of transcatheter aortic valve implantation (CT-TAVI) as currently performed in the UK.Methods408 members of the British Society of Cardiovascular Imaging were invited to complete a 27-item online CT-TAVI survey.Results47 responses (12% response rate) were received from 40 cardiac centres, 23 (58%) of which performed TAVI on-site (TAVI centres). Only six respondents (13%) performed high-volume activity (>200 scans per year) compared with 13 (28%) performing moderate (100–200 scans per year) and 27 (59%) performing low (0–99 scans per year) volume activity. Acquisition protocols varied (41% retrospective, 12% prospective with wide padding, 47% prospective with narrow padding), as did the phase of reporting (45% systolic, 37% diastolic, 11% both, 6% unreported). Median dose length product was 675 mGy.cm (IQR 477–954 mGy.cm). Compared with non-TAVI centres, TAVI centres were more likely to report minimum iliofemoral luminal diameter (n=25, 96% vs n=7, 58%, p=0.003) and optimal tube angulation for intervention (n=12, 46% vs n=1, 8%, p=0.02).ConclusionsThis national survey formally describes current CT-TAVI practice in the UK. High-volume activity was only present at one in seven cardiac CT centres. There is wide variation in scan acquisition, scan reporting and radiation dose exposure in cardiac CT centres.


2017 ◽  
Vol 86 (1-2) ◽  
Author(s):  
Anže Djordjević ◽  
Giuseppe D'Ancona ◽  
Axel Unbehaun ◽  
Stephan Kische ◽  
Hüseyin Ince ◽  
...  

Background: We report our experience with transcatheter aortic valve implantation (TAVI) in patients with bicuspid aortic valve (BAV) stenosis.Methods: Perioperative and intermediate-term follow-up data were retrospectively analysed. All procedures were performed within the premises of an experienced high-volume TAVI centre.Results: Tirty-three consecutive BAV patients (age 55 to 87 years) underwent TAVI. Mean logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE) was 23,2 ± 19,3. Transapical Edwards Sapien® valve was implanted in the majority of patients (87.9 %). Nine patients (27.3 %) required post-ballooning of the implanted valve for moderate to severe paravalvular leak, 3 patients (9 %) required a second valve implantation for persistent severe paravalvular leak, and 2 (6 %) required conversion to conventional surgery. Post-operative mild aortic regurgitation (AR) was presented in 12 patients (36.4%) and AR = 2 in 3 %. No AR > 2 was observed. Te device success rate according to the valve academic research consortium (VARC) criteria was 82 %. Similar BAV anatomy, calcium distribution, type and size of implanted valve were noticed in patients with and without residual AR. Tere was no thirty-day mortality. Two-year estimated survival was 70 % (CI: 52.7–93.1) and was similar in patients with and without post-procedural residual paravalvular leak.Conclusions: TAVI in BAV stenosis is feasible but, even in experienced centres, is technically more challenging and is associated with a higher rate of post-dilatation, re-valving, and conversion to conventional surgery. Results should be re-tested in light of the recent introduction of second-generation TAVI prostheses.


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