title: Transcatheter aortic valve implantation for severe regurgitation in native and degenerated bioprosthetic aortic valves.
abstract: OBJECTIVE
  We evaluated transcatheter aortic valve Implantation (TAVI) in high-risk patients with severe aortic regurgitation (AR) in native or degenerated bioprosthetic valves.
  
  
  BACKGROUND
  TAVI has emerged as a viable treatment modality for severe aortic stenosis in inoperable or high-risk patients. The use of TAVI for treatment of severe AR has remained largely unexplored.
  
  
  METHODS
  Eight patients (age 79.6 years ± 5.75 years) with severe AR underwent TAVI at six tertiary hospitals between April 2010 and May 2011. All patients were considered to be at prohibitive risk for surgical aortic valve replacement (SAVR).TAVI with the nitinol based Core Valve bioprosthesis (CRS) (Medtronic) was performed in all patients.
  
  
  RESULTS
  Transfemoral access was used in all cases. Procedural success was obtained in all cases without any intraprocedural complications. There was no in hospital or 30-day mortality. There were no cases of atrioventricular blocks requiring permanent pacemaker implantation. At a mean follow up of 15.5 ± 15 months; all patients had improvement in New York Heart Association functional class. Follow up echocardiography revealed improved or stable left ventricular ejection fraction and optimal device function in all cases.
  
  
  CONCLUSIONS
  TAVI with the CRS bioprosthesis is feasible and effective in appropriately selected cases of severe aortic regurgitation in native and bioprosthetic aortic valves.
authors.affiliation: Division of Cardiology, Ferrarotto Hospital, University of Catania, Italy.
authors.forename: Kunal
authors.initials: K
authors.lastname: Sarkar
authors.forename: Gennaro
authors.initials: G
authors.lastname: Sardella
authors.forename: Francesco
authors.initials: F
authors.lastname: Romeo
authors.forename: Mauro
authors.initials: M
authors.lastname: De Benedictis
authors.forename: Giandomenico
authors.initials: G
authors.lastname: Tarsia
authors.forename: Alessandro
authors.initials: A
authors.lastname: Iadanza
authors.forename: Samin K
authors.initials: SK
authors.lastname: Sharma
authors.forename: Marco
authors.initials: M
authors.lastname: Barbanti
authors.forename: Corrado
authors.initials: C
authors.lastname: Tamburino
authors.forename: Gian Paolo
authors.initials: GP
authors.lastname: Ussia
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000497:Alloys; D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D001705:Bioprosthesis; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D007558:Italy; D008297:Male; D011474:Prosthesis Design; D011475:Prosthesis Failure; D020127:Recovery of Function; D012307:Risk Factors; D012720:Severity of Illness Index; D013318:Stroke Volume; D062606:Tertiary Care Centers; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left
chemical_list: D000497:Alloys; C013616:nitinol