Percutaneous aortic valve replacement for the treatment of aortic stenosis: early experience in Brazil.
BACKGROUND
Percutaneous aortic valve replacement for the treatment of aortic stenosis is an available and efficient alternative for patients at high surgical risk, especially those with advanced age and comorbidities.


OBJECTIVE
The authors report the first experience made in our midst with the use of the CoreValve endoprosthesis.


METHODS
In January 2008, two patients underwent percutaneous aortic valve replacement due to symptomatic aortic stenosis. They were selected for being elderly (77 and 87 years) and presenting comorbidities and a high surgical risk (EuroScore 7.7% and 12.1%).


RESULTS
Percutaneous implantations of the CoreValve device were successfully performed. Enlargement of the valve area (from 0.7 to 1.5 cm(2) and from 0.5 to 1.3 cm(2)) and reduction of the aortic transvalvular gradient (from 82 to 50 mmHg and from 94 to 31 mmHg) were observed immediately after the intervention. During hospital stay, permanent pacemaker implantation was required in both patients due to atrioventricular block. At six months, an even greater drop in the aortic transvalvular gradient (gradient < 20 mmHg) and remission of symptoms of heart failure (NYHA III to NYHA I) were observed.


CONCLUSIONS
The use of the CoreValve endoprosthesis for the treatment of aortic stenosis proved to be feasible and showed encouraging results in this early experience made in our midst.
Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Marco Antonio
MA
Perin
Fábio Sândoli de
FS
Brito
Breno Oliveira
BO
Almeida
Marco Aurélio M
MA
Pereira
Alexandre
A
Abizaid
Flávio
F
Tarasoutchi
Eberhard
E
Grube
D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000473:pathology / Q000601:surgery*; D001705:Bioprosthesis; D006328:Cardiac Catheterization / Q000379:methods; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D015607:Stents