[Percutaneous aortic valve replacement - initial experience and results].
BACKGROUND
Aortic stenosis (AS) is the most common heart valvular disease and with progressive disease morbidity and mortality are substantial. The standard treatment in symptomatic patients is surgical valve replacement. However, one third of the patients with severe AS are inoperable due to advanced age and comorbidity. The aim of this study was to evaluate the results of percutaneous aortic valve replacement - a new treatment modality for patients with inoperable AS.


METHODS
A total of 20 patients were treated with CoreValve ReValving System valve prosthesis at the Copenhagen University Hospital in the period November 2007 to September 2008.


RESULTS
The procedural success was 100% and 30-day mortality was 5%, none of which was due to cardiac death. The treatment resulted in a considerable relief of symptoms. The aortic valve area showed a significant increase from 0.8 +/- 0.2 cm(2) to 1.9 +/- 0.6 cm(2) (p < 0.01). There was a significant decrease in the peak pressure gradient across the aortic valve from 75 +/- 38 mm Hg to 18 +/- 8 mm Hg (p < 0.01). Permanent pacemaker due to AV block was the most common complication with an incidence of 25% during the 30-day follow-up.


CONCLUSIONS
Implantation of a percutaneous aortic valve can be achieved in patients with inoperable AS and may become a very important therapeutic modality for this group of patients. These first results from Copenhagen University Hospital are promising and in concordance with international experience.
Kardiologisk Klinik B 2014, Rigshospitalet, DK-2100 København Ø.
Lene Kjaer
LK
Olsen
Thomas
T
Engstrøm
Kristian
K
Wachtell
Thomas
T
Kristensen
Christian
C
Hassager
Nikolaj
N
Ihlemann
Jacob Eifer
JE
Møller
Lars Willy
LW
Andersen
Peter Skov
PS
Olsen
Lars
L
Søndergaard
D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D011474:Prosthesis Design; D016896:Treatment Outcome