title: Transcatheter-based aortic valve implantations at midterm: what happened to our initial patients?
abstract: BACKGROUND
  This report analyzes a single institution's results with transapical aortic valve implantation (TAVI) from an initial series of patients over 5 years.
  
  
  METHODS
  A series of 100 patients underwent TAVI at our institution between January 2005 and December 2008. The mean patient age was 85 ± 6 years. All patients had a high perioperative risk for aortic valve replacement (mean logistic EuroSCORE of 36% ± 12%; Society of Thoracic Surgeons [STS] score 16% ± 3%). Clinical and echocardiographic variables were entered prospectively into a database. Late follow-up for survival, clinical outcomes including the New York Heart (NYHA) Association functional class, and echocardiographic assessment was 100% complete.
  
  
  RESULTS
  After a mean follow-up of 3.8 ± 2 years, overall mortality was 13% (n = 13/100), 30-day mortality was 8% (8/100), and late mortality was 5% (5/100). There were 2 perioperative repeated thoracotomies for bleeding, 2 intraoperative conversions, 1 prosthesis embolization, and 2 cases of impairment of coronary arteries. The causes of late mortality were cardiac failure (n = 2), respiratory failure (n = 1), renal failure (n = 1), and cancer (n = 1). At late follow-up there were no cases of endocarditis or stroke in any of the patients. None of the valves showed structural valve degeneration. NYHA functional class improved from 3.4 ± 0.4 before operation to 1.9 ± 0.5 at late follow-up (p = 0.02). Only 4 patients did not improve in functional class.
  
  
  CONCLUSIONS
  Midterm outcomes after TAVI in high-risk patients at our institution show an improvement in functional capacity, with a good survival rate. Valve degeneration is not an issue at midterm follow-up.
authors: Division of Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University, Frankfurt/Main, Germany. mirkodoss@aol.com
authors: Mirko
authors: M
authors: Doss
authors: Estelle Bianca
authors: EB
authors: Buhr
authors: Sven
authors: S
authors: Martens
authors: Anton
authors: A
authors: Moritz
authors: Andreas
authors: A
authors: Zierer
mesh_terms: D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000601:surgery*; D006328:Cardiac Catheterization; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome