title: Transapical aortic valve implantation in Rouen: four years' experience with the Edwards transcatheter prosthesis.
abstract: BACKGROUND
  The first French transapical transcatheter aortic valve implantation (TAVI) was performed in July 2007 in our department.
  
  
  OBJECTIVE
  To report 4-year outcomes of transapical implantation with the Edwards transcatheter bioprosthesis.
  
  
  METHODS
  We prospectively evaluated consecutive patients who underwent transapical implantation with an Edwards transcatheter bioprosthesis between July 2007 and October 2011. Patients were not suitable for conventional surgery (due to severe comorbidities) or transfemoral implantation (due to poor femoral access).
  
  
  RESULTS
  Among 61 patients (59.0% men), mean logistic EuroSCORE was 27.5 ± 14.9% and mean age was 81.0 ± 6.8 years. Successful valve implantation was achieved in 59/61 patients (96.7%) of patients. The other two patients required conversion to conventional surgery due to prosthesis embolization and died. Six additional patients died in the postoperative period. Causes of perioperative death were two septic shocks (one of peritonitis), two multi-organ failure, one ventricular fibrillation and one respiratory insufficiency. Intraprocedural stroke was not observed in any patient. The actuarial survival rates at 1, 2 and 4 years were 73.8%, 67.2% and 41.0%. During this 4-year period, four patients died of cardiovascular events, but no impairment of transprosthesis gradient was observed.
  
  
  CONCLUSIONS
  Our series of 61 patients who underwent transapical implantation of the Edwards transcatheter bioprosthesis shows satisfactory results, similar to other reports, considering the high level of severity of patients referred for this method. Transapical access is a reliable alternative method for patients that cannot benefit from a transfemoral approach.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Charles Nicolle University Hospital, Rouen, France. pierre-yves.litzler@chu-rouen.fr
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Litzler
authors.forename: Bogdan
authors.initials: B
authors.lastname: Borz
authors.forename: Hassiba
authors.initials: H
authors.lastname: Smail
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Baste
authors.forename: Catherine
authors.initials: C
authors.lastname: Nafeh-Bizet
authors.forename: Arnaud
authors.initials: A
authors.lastname: Gay
authors.forename: Christophe
authors.initials: C
authors.lastname: Tron
authors.forename: Matthieu
authors.initials: M
authors.lastname: Godin
authors.forename: Jerome
authors.initials: J
authors.lastname: Caudron
authors.forename: Camille
authors.initials: C
authors.lastname: Hauville
authors.forename: Jean-Nicolas
authors.initials: JN
authors.lastname: Dacher
authors.forename: Alain
authors.initials: A
authors.lastname: Cribier
authors.forename: Hélène
authors.initials: H
authors.lastname: Eltchaninoff
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Bessou
mesh_terms: D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D001705:Bioprosthesis; D006328:Cardiac Catheterization / Q000379:methods* / Q000401:mortality; D020099:Coated Materials, Biocompatible; D017548:Echocardiography, Transesophageal; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods* / Q000401:mortality; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011474:Prosthesis Design; D012720:Severity of Illness Index; D013318:Stroke Volume / Q000502:physiology; D015996:Survival Rate / Q000639:trends; D013997:Time Factors
chemical_list: D020099:Coated Materials, Biocompatible