Official journal of the Slovak Society of Cardiology,
Slovak Society of Hypertension and Slovak Association for Cardiac Arrhythmias

Cardiology Letters 2014, 23(3):207-214

Transcatheter implantation of the self-expandable aortic valve bioprosthesis in a

Fridrich V1, Gočár M1, Mizera S1, Postulka jr. J2, Malacký T3, Drangová E4, Vranka I1
1 Oddelenie intervenčnej kardiológie
2 Oddelenie neinvazívnej kardiológie
3 Oddelenie všeobecnej kardiológie
4 Oddelenie diagnostickej a intervenčnej rádiológie Národný ústav srdcových a cievnych chorôb, a. s. v Bratislave, Slovenská republika

The authors describe results from the single centre register of patients with severe aortic stenosis and high surgical risk treated with a transfemoral transcatheter implantation of self-expandable bioprosthesis.

Results: Included in the register were 49 consecutive patients with transcatheter implantation procedure performed between April 21st 2009 and June 20th 2013. The register contained 34 (69%) women and 15 (31%) men. The average age was 77.8±5.9 years (median 80.5; interval 68-89). The average NYHA was 3±0.5, the average Euro SCORE was 26.2±12. The procedure was performed in a cardiac catheterization laboratory under local anesthesia and patients were conscious and sedated. None of the patients died within 72 hours after implantation and the 30 day mortality rate was 2%, 1 year mortality rate was 16.2% and 2 years mortality rate was 25%. Maximal aortic gradient was significantly lower after the procedure (91.4±20.1 versus 17.7±3.5 mmHg; p<0.05) and remained without significant change for 2 years after (17.8±5.7 mmHg first year and 20.2±4.7 mmHg second year). 85% of the patients had zero or light, five had moderate (10.6%) and two severe (4%) aortic regurgitation. After the procedure, 58% of the patients were in sinus rhythm (before 59%; p=ns). A permanent pacemaker was implanted in 11 (23.4%) patients due to conduction disturbances.

Conclusion: Transcatheter implantation of the self-expandable bioprosthesis in patients with severe aortic stenosis, with suitable anatomy and high surgical risk, has a high success rate. The procedure also has a low perioperative, 30-day and 1-year mortality, with significant hemodynamic improvement which remained during the observation. The results of our register are comparable with published registers.

Keywords: single centre register; severe aortic stenosis; high operative risk; transcatheter implantation; self-expandable aortic bioprosthesis

Published: March 1, 2014  Show citation

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Fridrich V, Gočár M, Mizera S, Postulka J, Malacký T, Drangová E, Vranka I. Transcatheter implantation of the self-expandable aortic valve bioprosthesis in a. Cardiology Letters. 2014;23(3):207-214.
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