Single center experience with transcatheter aortic valve implantation using the Edwards SAPIEN™ Valve
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Single center experience with transcatheter aortic valve implantation using the Edwards SAPIEN™ Valve. / Nielsen, Hans Henrik Møller; Thuesen, Leif; Egeblad, Henrik; Poulsen, Steen Hvitfeldt; Klaaborg, Kaj-Erik; Jakobsen, Carl-Johan; Andersen, Henning Rud; Hjortdal, Vibeke Elisabeth.
In: Scandinavian Cardiovascular Journal, Vol. 45, No. 5, 10.2011, p. 261-6.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Single center experience with transcatheter aortic valve implantation using the Edwards SAPIEN™ Valve
AU - Nielsen, Hans Henrik Møller
AU - Thuesen, Leif
AU - Egeblad, Henrik
AU - Poulsen, Steen Hvitfeldt
AU - Klaaborg, Kaj-Erik
AU - Jakobsen, Carl-Johan
AU - Andersen, Henning Rud
AU - Hjortdal, Vibeke Elisabeth
PY - 2011/10
Y1 - 2011/10
N2 - OBJECTIVES: The use of transcatheter aortic valve implantation (TAVI) for high-risk patients was introduced in the early 2000s for treatment of aortic valve stenosis patients with too high surgical risk. During the last years, there has been a dramatic increase in TAVI procedures. TAVI programs are implemented in numerous cardiac centers. This paper describes a single center experience with its first 100 TAVI procedures.METHODS: This study included the first 100 patients who were scheduled for either transfemoral (F-TAVI) or transapical (A-TAVI) aortic valve implantation at Aarhus University Hospital, Skejby, using the Edwards SAPIEN™ valve. The indication for TAVI was unacceptable high predicted risk associated with conventional surgery. Patients with adequate diameter of iliac arteries were scheduled for F-TAVI, otherwise A-TAVI was preferred.RESULTS: The patients were treated between February 2006 and June 2010. Of these were 44% males and 56% females with a mean (S.D.) age of 81 (7.0). Thirty-days mortality rate was 8%, and decreased from 12% among the first 50 patients to 4% for the last 50 patients. Successful implantation was achieved in 92% patients. Major non-fatal complications were seen in 5% of 76 A-TAVI and in 0% of 24 F-TAVI patients. Mean (S.D.) EuroSCORE in the F-TAVI and A-TAVI groups was 15.9 (9.4) and 21.5 (14), respectively (p = 0.06). Post-procedural leakage of cardiac biomarkers was significantly higher in the A-TAVI group as compared to in the F-TAVI group. Mean (S.D.) NYHA class improved from 2.9 (0.6) to 1.8 (0.7) p < 0.001, with no significant difference between A-TAVI and F-TAVI patients.CONCLUSION: In surgically non-amenable patients, TAVI can be performed with acceptable mortality and morbidity and results in marked functional improvement. A decrease in 30-day mortality over time indicated a learning curve when implementing this treatment.
AB - OBJECTIVES: The use of transcatheter aortic valve implantation (TAVI) for high-risk patients was introduced in the early 2000s for treatment of aortic valve stenosis patients with too high surgical risk. During the last years, there has been a dramatic increase in TAVI procedures. TAVI programs are implemented in numerous cardiac centers. This paper describes a single center experience with its first 100 TAVI procedures.METHODS: This study included the first 100 patients who were scheduled for either transfemoral (F-TAVI) or transapical (A-TAVI) aortic valve implantation at Aarhus University Hospital, Skejby, using the Edwards SAPIEN™ valve. The indication for TAVI was unacceptable high predicted risk associated with conventional surgery. Patients with adequate diameter of iliac arteries were scheduled for F-TAVI, otherwise A-TAVI was preferred.RESULTS: The patients were treated between February 2006 and June 2010. Of these were 44% males and 56% females with a mean (S.D.) age of 81 (7.0). Thirty-days mortality rate was 8%, and decreased from 12% among the first 50 patients to 4% for the last 50 patients. Successful implantation was achieved in 92% patients. Major non-fatal complications were seen in 5% of 76 A-TAVI and in 0% of 24 F-TAVI patients. Mean (S.D.) EuroSCORE in the F-TAVI and A-TAVI groups was 15.9 (9.4) and 21.5 (14), respectively (p = 0.06). Post-procedural leakage of cardiac biomarkers was significantly higher in the A-TAVI group as compared to in the F-TAVI group. Mean (S.D.) NYHA class improved from 2.9 (0.6) to 1.8 (0.7) p < 0.001, with no significant difference between A-TAVI and F-TAVI patients.CONCLUSION: In surgically non-amenable patients, TAVI can be performed with acceptable mortality and morbidity and results in marked functional improvement. A decrease in 30-day mortality over time indicated a learning curve when implementing this treatment.
KW - Aged
KW - Aged, 80 and over
KW - Aortic Valve Stenosis/mortality
KW - Cardiac Catheterization/adverse effects
KW - Clinical Competence
KW - Denmark
KW - Female
KW - Heart Valve Prosthesis
KW - Heart Valve Prosthesis Implantation/adverse effects
KW - Hospital Mortality
KW - Hospitals, University
KW - Humans
KW - Learning Curve
KW - Male
KW - Prosthesis Design
KW - Registries
KW - Risk Assessment
KW - Risk Factors
KW - Time Factors
KW - Treatment Outcome
U2 - 10.3109/14017431.2011.575174
DO - 10.3109/14017431.2011.575174
M3 - Journal article
C2 - 21506661
VL - 45
SP - 261
EP - 266
JO - Scandinavian Cardiovascular Journal
JF - Scandinavian Cardiovascular Journal
SN - 1401-7458
IS - 5
ER -
ID: 242712498