title: Transcatheter aortic valve implantation: safety and effectiveness of the treatment of degenerated aortic homograft.
abstract: OBJECTIVE
  Percutaneous aortic valve implantation for patients with severe symptomatic aortic stenosis and a high surgical risk is currently well established. We report our experience in terms of safety and effectiveness of transcatheter aortic valve implantation in other clinical context like the degenerated aortic homografts.
  
  
  METHODS
  We report our initial experience in four hospitals and five patients with degenerated aortic homograft and severe aortic regurgitation, refused for surgery for a heart team, that underwent percutaneous implantation of CoreValve(®) aortic prosthesis.
  
  
  RESULTS
  We included three males and two females. The mean age was 70 (3.5) years. All patients were symptomatic in New York Heart Association class III or IV. Procedures were performed through one of the femoral arteries in all patients and under sedation in three patients. The implant was successfully carried out in all cases. There were no major complications during the procedure or admission and the valvular defect was solved in all cases. In-hospital and 30-days mortality was 0. All patients had clinical improvement during follow-up with a reduction in at less two grades in the New York Heart Association functional scale.
  
  
  CONCLUSIONS
  In our experience the treatment of degenerated aortic homografts and aortic insufficiency with transcatheter aortic valve implantation showed to be safe and effective. The current challenge is to convey the good results of transcatheter aortic valve implantation in symptomatic aortic stenosis and high surgical risk to others disorders of the aortic valve. In the future, it is possible that transcatheter aortic valve implantation will expand its indications to majority of aortic valve disorders and patients with less surgical risk.
authors.affiliation: Servicio de Cardiología, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain. birihh@yahoo.es
authors.forename: Diego
authors.initials: D
authors.lastname: López-Otero
authors.forename: Rui
authors.initials: R
authors.lastname: Teles
authors.forename: Joan A
authors.initials: JA
authors.lastname: Gómez-Hospital
authors.forename: Carlos S
authors.initials: CS
authors.lastname: Balestrini
authors.forename: Rafael
authors.initials: R
authors.lastname: Romaguera
authors.forename: José F
authors.initials: JF
authors.lastname: Saaibi-Solano
authors.forename: Jose
authors.initials: J
authors.lastname: Neves
authors.forename: Belen
authors.initials: B
authors.lastname: Cid-Alvarez
authors.forename: Joao
authors.initials: J
authors.lastname: Brito
authors.forename: Angel
authors.initials: A
authors.lastname: Cequier-Fillat
authors.forename: Ramiro
authors.initials: R
authors.lastname: Trillo-Nouche
mesh_terms: D000368:Aged; D001011:Aorta / Q000601:surgery; D001021:Aortic Valve / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000601:surgery; D006328:Cardiac Catheterization; D017023:Coronary Angiography; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D061214:Patient Safety; D013030:Spain; D014182:Transplantation, Autologous; D016896:Treatment Outcome