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.
Walther
Thomas
T
Department of Cardiac Surgery, Heartcenter, University Leipzig, Herzzentrum, Klinik für Herzchirurgie, Strümpellstrasse 39, Leipzig 04289, Germany. t.walther@kerckhoff-klinik.de
Schuler
Gerhard
G
Borger
Michael A
MA
Kempfert
Jörg
J
Seeburger
Jörg
J
Rückert
Yvonne
Y
Ender
Jörg
J
Linke
Axel
A
Scholz
Markus
M
Falk
Volkmar
V
Mohr
Friedrich W
FW
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