title: Percutaneous aortic valve implantation.
abstract: BACKGROUND
  Percutaneous aortic valve implantation is an emerging procedure for the treatment of patients with severe aortic stenosis.
  
  
  METHODS
  The procedure was performed in patients with severe symptomatic aortic stenosis, who had been refused for aortic valve replacement surgery. A self-expanding bioprosthesis within a nitinol frame delivered by an 18F catheter was used. Most of the procedures were performed through a femoral artery approach and under local anesthesia and sedation.
  
  
  RESULTS
  Thirty-two patients were treated, mean age 80 years, with various comorbidities and mean logistic EuroSCORE of 22%. The procedure was successful in all patients, with a significant improvement in transvalvular gradients. Two patients died due to procedure-related complications. The most common complications were vascular access related and high-degree atrioventricular block requiring permanent pacemaker. No events were reported after one month follow-up, with most patients showing improvement in functional capacity. After 23 months of follow-up (mean 13 months) five additional deaths had occurred. No prosthesis-related events were observed.
  
  
  CONCLUSIONS
  Percutaneous aortic valve implantation is safe and improves quality of life in patients with severe symptomatic aortic stenosis. It may be an alternative therapeutic option for patients with high risk features for aortic replacement surgery.
authors.affiliation: Serviço de Cardiologia, Centro Hospital Gaia/Espinho EPE, Vila Nova de Gaia, Portugal. danicaeiro@hotmail.com
authors.forename: Daniel
authors.initials: D
authors.lastname: Caeiro
authors.forename: R
authors.initials: R
authors.lastname: Fontes-Carvalho
authors.forename: Rui
authors.initials: R
authors.lastname: Lima
authors.forename: Bruno
authors.initials: B
authors.lastname: Melica
authors.forename: Lino
authors.initials: L
authors.lastname: Santos
authors.forename: Alberto
authors.initials: A
authors.lastname: Rodrigues
authors.forename: Pedro
authors.initials: P
authors.lastname: Braga
authors.forename: Manuel
authors.initials: M
authors.lastname: Gonçalves
authors.forename: Aníbal
authors.initials: A
authors.lastname: Albuquerque
authors.forename: Vasco
authors.initials: V
authors.lastname: Gama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000601:surgery*; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D012720:Severity of Illness Index