Resultados imediatos e seguimento clínico dos pacientes submetidos a implante valvar aórtico transcateter

Abstract

background: One third of the elderly population with symptomatic calcified aortic stenosis cannot undergo surgery due to their high operative risk. The transcatheter aortic-valve implantation (TAVI) has emerged as an alternative therapy for this group of patients. Methods: All patients submitted to TAVI from November 2008 to April 2012 were included in our study. We report the baseline clinical characteristics, procedural data, hospital outcomes and clinical follow-up of this population. Definitions were based on the Valve Academic Research Consortium criteria. Results: TAVI was performed in 23 patients, with 79 ± 6.7 years of age, and 56% were female. The EuroSCORE was 20.4 ± 11.1%. The CoreValve ® prosthesis was used in 19 patients (82.6%) and the Edwards SAPIEN™ valve was used in the remaining ones. Procedure success rate was 96%. The mean follow-up was 22 ± 12.8 months, with 6 deaths (26.1%) in this period, 3 of which were observed in the first 30 days (13%) and other 2 (21.7%) by the end of the first year. One patient had a transient ischemic attack during hospitalization (4.3%), but there were no episodes of stroke or myocardial infarction in the periprocedural period or in the follow-up. The composite safety endpoint at 30 days was observed in 5 patients (21.7%) and the composite efficacy endpoint at 12 months was 78.3%. Conclusions: The results of this study demonstrate that TAVI is an attractive procedure for

Initial Experience of Two National Centers in Transcatheter Aortic Prosthesis Implantation

“…Although the patients included here have high risk of morbidity and mortality, with a mean EuroScore of 23%, mortality from all causes was 14%, which is similar to or lower than that reported in other national and international case series 6 , 7 , 14 , 15 . It is noteworthy that mortality is also related to the learning curve of the multidisciplinary team, as when the first 40 patients were excluded, the mortality rate decreased to 8.1%.…”

“…Finally, regarding the transcatheter prosthesis durability, several studies, as well as the current one, evaluated immediate echocardiographic outcomes, as well as during late follow-up, confirming prosthesis hemodynamic maintenance 7 , 19 , 29 .…”