title: Transcatheter bioprosthesis implantation for the treatment of aortic stenosis: three-year experience.
abstract: BACKGROUND
  Transcatheter aortic bioprosthesis implantation is a new treatment modality for patients with aortic stenosis who are inoperable or at high surgical risk.
  
  
  OBJECTIVE
  To report the three-year experience with transcatheter CoreValve® bioprosthesis implantation.
  
  
  METHODS
  From January 2008 to January 2011, 35 patients with aortic stenosis (33) or aortic valve bioprosthesis dysfunction (two) at high surgical risk underwent transcatheter CoreValve® bioprosthesis implantation.
  
  
  RESULTS
  The patients' mean age was 81.5 ± 9 years, and 80% had heart failure functional class III or IV. The EuroScore was 18.4 ± 14.3% and the STS risk score was 14.5 ± 11.6%. Successful device implantation was achieved in 34 (97.1%) patients. After the intervention, a reduction in the transvalvular pressure gradient from 84.9 ± 22 to 22.5 ± 9.5 mm Hg was observed, and 87.1% of the patients progressed to functional class I or II. Thirty-day mortality and mortality in the follow-up of 400 ± 298 days were 11.4% and 31.4%, respectively. The occurrence of life-threatening hemorrhagic complications was the only independent predictor of cardiovascular mortality. Stroke occurred in 5.7% of the patients. Permanent pacemaker was required in 32.1% of the patients within the first month after the procedure.
  
  
  CONCLUSIONS
  Transcatheter aortic bioprosthesis implantation is a safe and effective procedure to be used in patients with aortic stenosis at high surgical risk. The CoreValve® prosthesis proved to have mid-term efficacy in a three-year follow-up.
authors: Hospital Israelita Albert Einstein, São Paulo, SP, Brasil. fsbrito@superig.com.br
authors: Fabio Sandoli de
authors: FS
authors: Brito Junior
authors: Alexandre
authors: A
authors: Abizaid
authors: Breno O
authors: BO
authors: Almeida
authors: Adriano
authors: A
authors: Caixeta
authors: Flávio
authors: F
authors: Tarasoutchi
authors: Eberhard
authors: E
authors: Grube
authors: Marco
authors: M
authors: Perin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000628:therapy*; D001705:Bioprosthesis; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods*; D023381:Endpoint Determination; D004812:Epidemiologic Methods; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016896:Treatment Outcome