Percutaneous implantation of self-expandable aortic valve in high risk patients with severe aortic stenosis: The first experiences in Serbia
Background/Aim. Aortic stenosis (AS) is the most common valvular heart disease in elderly people, with rather poor prognosis in symptomatic patients. Surgical valve replacement is the therapy of choice, but a significant number of patients cannot undergo surgical procedure. We presented...
Main Authors: | , , , , , , , , , , , , , , |
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Format: | Article |
Language: | English |
Published: |
Military Health Department, Ministry of Defance, Serbia
2016-01-01
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Series: | Vojnosanitetski Pregled |
Subjects: | |
Online Access: | http://www.doiserbia.nb.rs/img/doi/0042-8450/2016/0042-84501500024N.pdf |
Summary: | Background/Aim. Aortic stenosis (AS) is the most common valvular heart
disease in elderly people, with rather poor prognosis in symptomatic
patients. Surgical valve replacement is the therapy of choice, but a
significant number of patients cannot undergo surgical procedure. We
presented initial experience of transcatheter aortic valve implantation
(TAVI) performed in Catheterization Laboratory of the Clinic for Cardiology,
Clinical Center of Serbia. Methods. The procedures were performed in 5
patients (mean age 76 ± 6 years, 2 males, 3 female) with severe and
symptomatic AS with contraindication to surgery or high surgical risk. The
decision to perform TAVI was made by the heart team. Pre-procedure screening
included detailed clinical and echocardiographic evaluation, coronary
angiography and computed tomography scan. In all the patients we implanted a
self-expandable aortic valve (Core Valve, Medtronic, USA). Six months
follow-up was available for all the patients. Results. All interventions were
successfully performed without significant periprocedural complications.
Immediate hemodynamic improvement was obtained in all the patients (peak
gradient 94.2 ± 27.6 to 17.6 ± 5.2 mmHg, p < 0.001, mean pressure gradient
52.8 ± 14.5 to 8.0 ± 2.1 mmHg, p < 0.001). None of the patients developed
heart block, stroke, vascular complication or significant aortic
regurgitation. After 6 months, the survival was 100% with New York Heart
Association (NYHA) functional improvement in all the patients. Conclusion.
This successful initial experience provides a solid basis to treat larger
number of patients with symptomatic AS and high surgical risk who are left
untreated. [Projekat Ministarstva nauke Republike Srbije, br. ON 175 020] |
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ISSN: | 0042-8450 2406-0720 |