Transcatheter Aortic Valve Implantation
2009; Lippincott Williams & Wilkins; Volume: 119; Issue: 23 Linguagem: Inglês
10.1161/circulationaha.108.837807
ISSN1524-4539
AutoresJohn G. Webb, Lukas Altwegg, Robert Boone, Anson Cheung, Jian Ye, Samuel V. Lichtenstein, May Lee, Jean Bernard Masson, Christopher Thompson, Robert Moss, Ron Carere, Brad Munt, Fabian Nietlispach, Karin H. Humphries,
Tópico(s)Aortic Disease and Treatment Approaches
ResumoTranscatheter aortic valve implantation is an alternative to open heart surgery in patients with aortic stenosis. However, long-term data on a programmatic approach to aortic valve implantation remain sparse.Transcatheter aortic valve implantation was performed in 168 patients (median age, 84 years) in the setting of severe aortic stenosis and high surgical risk. Access was transarterial (n=113) or, in the presence of small iliofemoral artery diameter, transapical (n=55). The overall success rate was 94.1% in this early experience. Intraprocedural mortality was 1.2%. Operative (30-day) mortality was 11.3%, lower in the transarterial group than the transapical group (8.0% versus 18.2%; P=0.07). Overall mortality fell from 14.3% in the initial half to 8.3% in the second half of the experience, from 12.3% to 3.6% (P=0.16) in transarterial patients and from 25% to 11.1% (P=0.30) in transapical patients. Functional class improved over the 1-year postprocedure period (P 3 years and a median of 221 days, structural valve failure was not observed.Transcatheter aortic valve implantation can result in early and sustained functional improvement in high-risk aortic stenosis patients. Late outcome is determined primarily by comorbidities unrelated to aortic valve disease.
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