Twelve-month outcomes of transapical transcatheter aortic valve implantation in patients with severe aortic valve stenosis

Abstract

Introduction: Transapical access (TA) transcatheter aortic valve implantation (TAVI) (TA-TAVI) represents one of the possible routes in patients with severe aortic stenosis (AS) who are not suitable for transfemoral access.Aim: To assess early-and mid-term clinical outcomes after TA-TAVI. Material and methods: Patients with severe symptomatic AS undergoing TA-TAVI from November 2008 to December 2019 were enrolled. Clinical and procedural characteristics as well as clinical outcomes including all-cause mortality during 12-month follow-up were assessed.Results: Sixty-one consecutive patients underwent TA-TAVI for native AS. Patients were elderly with median age of 80.0 (76.0-84.0) years; 55.7% were males. Median baseline EuroSCORE I and STS scores were 18.2% (11.6-27.7) and 4.8% (3.3-8.2), respectively. The procedural success rate was 96.7%. In-hospital, 30-day and 12-month mortality rates were 9.8%; 18.0% and 24.6%, respectively. The main periprocedural and in-hospital complications were bleeding complications (14.8%). The following factors were associated with 12-month mortality: previous cerebrovascular event (CVE), glomerular filtration rate (GFR), aortic valve area (AVA), right ventricular systolic pressure (RVSP) and serum level of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) (

Comparison of transcarotid versus transapical transcatheter aortic valve implantation outcomes in patients with severe aortic stenosis and contraindications for transfemoral access

“…There were some differences in the baseline hemoglobin levels; however, they were not marked, and the frequency of anemia was similar. Patient selection is crucial because TF access provides the lowest risk of complications, and the decision to switch to an alternative access should be based on thorough Heart Team discussion [ 16 , 17 ]. TA access, as the more invasive, is currently used less across Europe and the United States of America than in the early era of TAVI (a decline from 17% to 4% in French registries) as seen in the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry [ 5 , 18 ].…”

Impact of diabetes mellitus on the diagnostic performance of fractional flow reserve in patients with severe aortic stenosis

“…Due to the aging population and increasing number of elderly patients with severe AS, the problem of their treatment is growing [2,6,7]. More importantly, concomitant CAD and diabetes mellitus are highly prevalent and may affect the outcomes for those patients [2][3][4][5][6]. Current ESC/EACTS Guidelines for the management of valvular heart disease recommend surgical revascularization of coronary artery diameter stenosis of ≥70% (≥50% for left main) in patients with a primary indication for aortic valve surgery [7].…”

“…As calcific aortic valve stenosis (AS) and coronary artery disease (CAD) share common risk factors, CAD is quite prevalent among patients with severe AS [1][2][3][4][5][6]. More importantly, CAD is associated with worse outcomes of transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) in patients with severe AS [2][3][4][5]. Thus, assessment of CAD in those patients is of particular importance.…”