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Transapical aortic valve implantation at 3 years
- Source :
- The Journal of Thoracic and Cardiovascular Surgery. 143:326-331
- Publication Year :
- 2012
- Publisher :
- Elsevier BV, 2012.
-
Abstract
- Objective Our objective was to analyze the results of transapical aortic valve implantation in high-risk patients with aortic stenosis at up to 3 years after the procedure. Methods A total of 299 patients underwent transapical aortic valve implantation from February 2006 until January 2010 using the Edwards SAPIEN transcatheter xenograft. Mean patient age was 82 ± 6 years and 70% were female. Logistic EuroSCORE and Society of Thoracic Surgeons score predicted risks for mortality were 31% ± 16% and 12% ± 8%, respectively. All patients were treated in a hybrid operative theater by a team of anesthetists, cardiologists and cardiac surgeons. Results Successful valve implantation was performed in all patients. Transapical aortic valve implantation was uneventful in 267 patients (89.3%), whereas 32 patients (10.7%) required additional interventions. Such interventions included cardiopulmonary bypass support in 18, implantation of a second SAPIEN valve in 15, coronary intervention in 9, conversion to conventional surgery in 6, and annulus perforation in 3 patients (not mutually exclusive). Intraprocedural stroke was not observed in any patient, although 2 (0.7%) patients had a delayed stroke during their hospital stay. Overall survival was 91% at 30 days, 73% at 1 year, 68% at 2 years, and 58% at 3 years. Conclusions Transapical aortic valve implantation can be performed with good outcomes in high-risk patients with aortic stenosis. Perioperative complications occur in approximately 10% of patients, and a variety of interventions are required for these events. We believe a team approach is therefore essential for the success of transapical aortic valve implantation
- Subjects :
- Male
Pulmonary and Respiratory Medicine
Aortic valve
Cardiac Catheterization
medicine.medical_specialty
Time Factors
Perforation (oil well)
Conventional surgery
Kaplan-Meier Estimate
Prosthesis Design
Risk Assessment
law.invention
Aortic valve replacement
Risk Factors
law
Germany
Internal medicine
Cardiopulmonary bypass
medicine
Humans
Hospital Mortality
Stroke
Aged
Aged, 80 and over
Bioprosthesis
Heart Valve Prosthesis Implantation
business.industry
Patient Selection
Aortic Valve Stenosis
Perioperative
medicine.disease
Surgery
Stenosis
Logistic Models
Treatment Outcome
medicine.anatomical_structure
Cardiovascular Diseases
Heart Valve Prosthesis
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 00225223
- Volume :
- 143
- Database :
- OpenAIRE
- Journal :
- The Journal of Thoracic and Cardiovascular Surgery
- Accession number :
- edsair.doi.dedup.....5393efa0eef5e916fbcee112fdb094eb