[Catheter-based aortic valve substitution. Initial experiences with stent valve implantation].
BACKGROUND
Recent years have seen the introduction of catheter-based aortic valve substitution with stent valves to treat aortic valve stenosis in patients who were deemed inoperable via conventional open heart surgery. We here report our initial experience.


METHODS
Register-based study with prospective registration of prespecified parameters. A total of 26 patients were treated with an aortic stent valve, 12 via transfemoral (TFA-AVI) and 14 via transapical (TAP-AVI) access. In the TFA-AVI group, 75% were women and the average age was 85 4.5 years; in the TAP-AVI group, 71% were women and the average age was 79 8.4 years.


RESULTS
In the TFA-AVI group, successful stent valve implantation was performed in 9/12 (75%) and TAP-AVI in 13/14 (93%) patients. Mortality after 30 days was 25% in the TFA-AVI and 7% in the TAP-AVI group. The aortic valve area increased from 0.6 0.13 cm(2) to 1.6 0.39 (2) in the TFA-AVI group and from 0.7 0.2 (2) to 1.6 0.37 (2) in the TAP-AVI group. 91% of patients showed clinical improvement after treatment.


CONCLUSIONS
Transcatheter aortic valve implantation of conventional unresectable patients requires close cooperation between different specialities. The treatment seems to be a realistic alternative to medical treatment for inoperable patients and may even be used in operable high-risk patients.
Nielsen
Hans Henrik Møller
HH
Hjerte-, Lunge- og Karkirurgisk Afdeling T, Arhus Universitetshospital, Skejby, DK-8200 Arhus. hhmn@kirurgi.org
Andersen
Henning Rud
HR
Hjortdal
Vibeke Elisabeth
VE
Klaaborg
Kaj-Erik
KE
Jakobsen
Carl-Johan
CJ
Egeblad
Henrik
H
Terp
Kim
K
Lindskov
Christian
C
Sloth
Erik
E
Poulsen
Steen Hvidtfeldt
SH
Bøing
Ingeborg
I
Thuesen
Leif
L
D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001705:Bioprosthesis; D006328:Cardiac Catheterization / Q000379:methods*; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation / Q000379:methods; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012042:Registries; D015607:Stents; D016896:Treatment Outcome