title: Transcatheter aortic valve implantation: first Greek experience.
abstract: BACKGROUND
  Percutaneous aortic valve replacement represents an alternative to conventional open-heart surgery for selected high-risk patients without the need for sternotomy, aortotomy, or cardiopulmonary bypass. We present the first Greek series of transcatheter prosthetic aortic valve implantation procedures, performed in our centre.
  
  
  METHODS
  All 12 patients (age 81 +/- 5 years) had severe, symptomatic, calcific aortic stenosis and were judged not to have a reasonable surgical option by a medical team including experienced cardiac surgeons. The patients' mean logistic EuroSCORE was 34 +/- 15% (min 11%, max 61%). Eight (8) of them underwent transfemoral (SAPIEN, Edwards 23 mm valve in 7 and 26 mm in 1 patient) and 4 transapical (26 mm in 2 and 23 mm in 2 patients) prosthetic aortic valve implantation, all in the cardiac catheterisation laboratory under general anaesthesia.
  
  
  RESULTS
  The procedural, in-hospital and 2-month (mean follow up 50 days, min 17, max 122 days) mortality was 0%. The length of hospital stay was 8 +/- 2 days (min 5, max 12 days). The aortic valve area increased from 0.64 +/- 0.14 cm2 to 1.83 +/- 0.14 cm2 and the mean pressure gradient decreased from 57 +/- 23 mmHg to 10 +/- 3 mmHg post-implantation (p<0.001 for both). The patients' mean NYHA functional status improved from 2.8 +/- 0.7 to 1.3 +/- 0.5 at follow-up (p<0.001).
  
  
  CONCLUSIONS
  Our initial experience with transcatheter prosthetic aortic valve implantation demonstrates that it can be performed safely and with excellent short and mid-term clinical outcomes.
authors.affiliation: Department of Cardiology A', Onassis Cardiac Surgery Centre, Athens, Greece. spargias@ocsc.gr
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Spargias
authors.forename: Athanassios
authors.initials: A
authors.lastname: Manginas
authors.forename: Gregory
authors.initials: G
authors.lastname: Pavlides
authors.forename: Mazen
authors.initials: M
authors.lastname: Khoury
authors.forename: George
authors.initials: G
authors.lastname: Stavridis
authors.forename: Panagiota
authors.initials: P
authors.lastname: Rellia
authors.forename: Anna
authors.initials: A
authors.lastname: Smirli
authors.forename: Apostolos
authors.initials: A
authors.lastname: Thanopoulos
authors.forename: Marina
authors.initials: M
authors.lastname: Balanika
authors.forename: Spyros
authors.initials: S
authors.lastname: Polymeros
authors.forename: Sofia
authors.initials: S
authors.lastname: Thomopoulou
authors.forename: George
authors.initials: G
authors.lastname: Athanassopoulos
authors.forename: George
authors.initials: G
authors.lastname: Karatasakis
authors.forename: Renata
authors.initials: R
authors.lastname: Mastorakou
authors.forename: Stavroula
authors.initials: S
authors.lastname: Lacoumenta
authors.forename: Alkis
authors.initials: A
authors.lastname: Michalis
authors.forename: Petros
authors.initials: P
authors.lastname: Alivizatos
authors.forename: Dennis
authors.initials: D
authors.lastname: Cokkinos
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000601:surgery; D006328:Cardiac Catheterization; D017023:Coronary Angiography; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D007902:Length of Stay; D008297:Male; D011379:Prognosis