Transapical aortic valve implantation in 100 consecutive patients: comparison to propensity-matched conventional aortic valve replacement.
OBJECTIVE
To evaluate the outcome of transapical aortic valve implantation (TA-AVI) in comparison to conventional surgery.


RESULTS
One hundred consecutive high-risk patients with symptomatic aortic valve stenosis received TA-AVI using the Edwards SAPIEN pericardial xenograft between February 2006 and January 2008. Patient age was 82.7 +/- 5 years, 77 were females, logistic EuroSCORE predicted risk of mortality was 29.4 +/- 13% and Society Thoracic Surgeons score risk for mortality was 15.2 +/- 8.3%. Propensity score analysis was used to identify a control group of patients that underwent conventional aortic valve replacement (C-AVR). Transapical aortic valve implantation was performed successfully in 97 patients, whereas three patients required early conversion. There were no new onset neurological events in the TA-AVI group and early extubation was performed in 82 patients. Echocardiography revealed good valve function with low transvalvular gradients in all patients. Thirty-day survival was 90 +/- 3 vs. 85 +/- 4% for TA-AVI vs. C-AVR, and 1-year survival was 73 +/- 4 vs. 69 +/- 5% (P = 0.55).


CONCLUSIONS
Transapical aortic valve implantation is a safe, minimally invasive, and off-pump technique to treat high-risk patients with aortic stenosis. Results of the initial 100 patients are good and compare favourably to conventional surgery.
Department of Cardiac Surgery, Heartcenter, University Leipzig, Herzzentrum, Klinik für Herzchirurgie, Strümpellstrasse 39, Leipzig 04289, Germany. t.walther@kerckhoff-klinik.de
Thomas
T
Walther
Gerhard
G
Schuler
Michael A
MA
Borger
Jörg
J
Kempfert
Jörg
J
Seeburger
Yvonne
Y
Rückert
Jörg
J
Ender
Axel
A
Linke
Markus
M
Scholz
Volkmar
V
Falk
Friedrich W
FW
Mohr
D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000601:surgery*; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods / Q000401:mortality; D011182:Postoperative Care; D011300:Preoperative Care; D057216:Propensity Score; D012189:Retrospective Studies; D012307:Risk Factors; D014183:Transplantation, Heterologous; D016896:Treatment Outcome