First experience without pre-ballooning in transapical aortic valve implantation: a propensity score-matched analysis.
نویسندگان
چکیده
OBJECTIVES Transapical aortic valve implantation (TA-AVI) using the Edwards SAPIEN™ prosthesis has evolved into a routine procedure for selected high-risk elderly patients. The recently introduced SAPIEN™ delivery system (Ascendra II+™) with an added nose cone seems to facilitate direct valve implantation without prior balloon valvuloplasty (BAV). Here, we report our initial experience with this device. METHODS A total of 128 patients were enrolled in the study in 2012 and 2013 and were designated Cohort I. For a subset of 79 patients, exact cardio- computed tomography-based measurements were available; these patients were assigned to Cohort II. All patients received SAPIEN XT™ valves using the TA approach. TA-AVI without pre-ballooning was performed in 31.2% (Cohort I) and 31.6% (Cohort II) of patients. To adjust for baseline variables, propensity score (PS)-based pair matching was used. RESULTS All valves were implanted successfully. The use of PS matching resulted in bias reduction for both cohorts. For Cohort I, there were no significant differences in the primary end points, which were aortic valve incompetence≥2+, Pmean postimplantation, major stroke, transient ischaemic attack (TIA), requirement for post-dilatation and necessity for new pacemaker implantation. As expected, fluoroscopy time was significantly lower in no-BAV patients. In Cohort II, the 30-day TIA rate was lower in the no-BAV group. CONCLUSIONS Direct TA implantation of the SAPIEN valve without pre-ballooning is feasible, safe, does not seem to compromise functional outcomes and may be associated with fewer neurological events.
منابع مشابه
Comparison of two valve systems for transapical aortic valve implantation: a propensity score-matched analysis.
OBJECTIVES Several alternative transapical (TA) aortic prostheses for aortic valve implantation (AVI) have recently become available. Data directly comparing the performance of these different TA-AVI valves, however, are sparse. Therefore, we sought to analyse the performance of the better-established balloon-expandable SAPIEN XT™ valve system, and compare it with the recently approved self-exp...
متن کاملLong-term results of transapical versus transfemoral TAVI in a real world population of 1000 patients with severe symptomatic aortic stenosis.
BACKGROUND Transapical transcatheter aortic valve implantation is generally perceived to be associated with increased morbidity compared with transfemoral transcatheter aortic valve implantation. We aimed to compare access-related complications and survival using propensity score matching. METHODS AND RESULTS Prospective, single-center registry of 1000 consecutive patients undergoing transapi...
متن کاملTransapical aortic valve implantation in 100 consecutive patients: comparison to propensity-matched conventional aortic valve replacement.
AIMS To evaluate the outcome of transapical aortic valve implantation (TA-AVI) in comparison to conventional surgery. METHODS AND RESULTS One hundred consecutive high-risk patients with symptomatic aortic valve stenosis received TA-AVI using the Edwards SAPIEN pericardial xenograft between February 2006 and January 2008. Patient age was 82.7 +/- 5 years, 77 were females, logistic EuroSCORE pr...
متن کاملTransapical aortic valve implantation in patients with previous cardiac surgery.
BACKGROUND This study compared surgical outcomes of patients with previous cardiac surgery undergoing transapical transcatheter aortic valve implantation (PCS-TA-TAVI) with those of patients undergoing transapical transcatheter aortic valve implantation as an initial procedure (initial TA-TAVI) by using propensity analysis. METHODS From January 2005 through January 2013, 267 consecutive high-...
متن کاملTransapical versus transfemoral aortic valve implantation: a comparison of survival and safety.
BACKGROUND Transcatheter aortic valve implantation (TAVI) is a therapeutic option for high-risk patients with aortic stenosis. Procedural mortality remains high in comparison with conventional aortic valve replacement (AVR) because patients determined for TAVI are commonly denied conventional surgery. We aimed to evaluate access-related complications between the transfemoral (TF) and the transa...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
دوره 47 1 شماره
صفحات -
تاریخ انتشار 2015