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| Transapical Aortic Valve Implantation at Three Years |
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Thomas Walther, Joerg Kempfert, Michael A. Borger, Ardawan J. Rastan, Axel Linke, Gerhard Schuler, Friedrich W. Mohr Cardiac Surgery, Heartcenter Leipzig, Leipzig, Germany Objective: Transapical (TA) aortic valve implantation (AVI) has been introduced into clinical practice in 2006 to treat high risk patients with symptomatic aortic stenosis. The aim of this study was to evaluate the results of minimally invasive TA-AVI at three years. Methods: From February 2006 until October 2009 a total of 267 high risk patients with symptomatic aortic stenosis received TA-AVI using the Edwards SAPIEN™ transcatheter xenograft. Patient age was 82 ±6 years, 70% were female. Logistic EuroSCORE was 32 ±16% and STS score 12 ±7%. All patients referred that presented with an aortic annulus diameter ≤24mm were included into this study. Initially ten patients were treated on-pump, then an off-pump protocol with safety net femoral wires to allow for potential conversion was used. All procedures were performed in a hybrid operative theatre. Results: Transapical access was feasible in all patients. TA-AVI was performed completely off-pump in 90% of the patients, 6.6% had to be converted on-pump. Five patients required conversion to sternotomy, three of them survived. Survival at 30 days was 90%, at one year 70%, at two years 68% and at three years 56%. There were two minor strokes on POD 1 and 2, both with good functional recovery. One patient presented with endocarditis at three weeks post AVI, after conversion she lateron died due to sepsis. Systematic evaluation revealed that patients reached a good quality of life at three months after TA-AVI, quite comparable to an age matched control population. Conclusion: TA-AVI can be performed with good outcome in high risk patients with aortic stenosis. Optimal imaging and a team approach are essential for success. Back to 2010 Annual Meeting Back to Program Outline Back to Main Program |
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Copyright © 2012 American Association for Thoracic Surgery
All rights reserved. IMPORTANT REMINDER: The preceding information is intended only to provide
general guidance and not as a definitive basis for diagnosis or treatment in any particular case.
It is very important that you consult a doctor about any specific medical problem or question.
All rights reserved. IMPORTANT REMINDER: The preceding information is intended only to provide
general guidance and not as a definitive basis for diagnosis or treatment in any particular case.
It is very important that you consult a doctor about any specific medical problem or question.