[Implantation of aortic valvular prosthesis via transfemoral catheter. Evaluation of candidates undergoing the procedure].
OBJECTIVE
In recent years, techniques for implantation of aortic prosthesis via catheter have been developed as a therapeutic alternative in patients with severe aortic stenosis rejected for surgery. The correct selection of candidates is one of the more complex aspects of this treatment. We analyzed the acceptance rate in our environment for transcatheter aortic valve implantation in patients referred to our hospital for evaluation as possible candidates, describing the exclusion reasons.


METHODS
30 patients with severe aortic stenosis and rejected for surgical aortic valve replacement were referred to our hospital to evaluate transcatheter aortic valve implantation. The patients first underwent clinical evaluation and were studied with echocardiography, angiography and computed tomography.


RESULTS
Of the 30 patients, 18 were rejected for the procedure (60%): 4 patients with non-severe aortic stenosis, 2 asymptomatic patients, 2 patients who finally underwent surgery because of a low-surgical-risk, 5 patients with contraindications for the procedure, 2 patients who finally did not want to undergo the procedure and 3 patients were further rejected because the vascular access was inappropriate. Of the remaining 12 patients initially accepted, 3 died before the procedure was performed. Finally, only 9 patients (30%) underwent transcatheter aortic valve implantation.


CONCLUSIONS
Of the patients referred for transcatheter aortic valve implantation, only 40% were accepted. The mortality rate during the evaluation process of this procedure is high, showing that these patients are terminally ill.
Dobarro
David
D
Unidad de Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario La Paz, Madrid, España.
Moreno
Raúl
R
Filgueiras
David
D
Calvo
Luis
L
López-Fernández
Teresa
T
Sánchez-Recalde
Angel
A
Jiménez-Valero
Santiago
S
Galeote
Guillermo
G
Gómez-Rubín
María Del Carmen
Mdel C
Moreno-Gómez
Isidro
I
Mesa
Jose-María
JM
Plaza
Ignacio
I
López-Sendón
José Luis
JL
D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D002404:Catheterization; D005260:Female; D005263:Femoral Artery; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male