title: Two-year outcomes for patients with severe symptomatic aortic stenosis treated with transcatheter aortic valve implantation.
abstract: Transcatheter aortic valve implantation (TAVI) is an emerging technique for the treatment of severe symptomatic aortic stenosis. Little has been reported about the use of different devices and multiple catheter-based options and anesthetic techniques in the same institution. We report the long-term clinical experience in treating patients with severe symptomatic aortic stenosis using TAVI. We analyzed the outcomes of 153 TAVI-treated patients who were followed for ≤2 years. All patients were at very high risk of surgical valve replacement. The Medtronic-CoreValve device was used in 59.5% and the Edwards-SAPIEN device in 40.5% of the patients. The primary end point was death from any cause during follow-up. The mean ± SD patient age was 81.1 ± 6 years, and 62% of the patients were women. The procedural success rate was 97.4%. At 30 days of follow-up, the all-cause mortality was 3.9%. Two-year follow-up data were obtained for 108 patients, with 85.5% survival of treated patients. The 30-day stroke rate was 3.9%. No significant differences in mortality were found when angioplasty was performed before or during TAVI compared with TAVI alone. Multivariate analysis showed that increased baseline creatinine (hazard ratio 1.55, 95% confidence interval 1.01 to 2.42, p = 0.049) and increased logistic European System for Cardiac Operative Risk Evaluation score (hazard ratio 1.03, 95% confidence interval 1.01 to 1.06, p = 0.048) predicted all-cause mortality. In conclusion, the clinical outcome of TAVI is favorable. The use of both procedural devices and multiple techniques in the same institution is feasible and potentially desirable.
authors: Department of Cardiology, Beilinson Hospital, Rabin Medical Center, Petach-Tikva, and Tel-Aviv University, Sackler Faculty of Medicine, Tel-Aviv, Israel.
authors: Pablo
authors: P
authors: Codner
authors: Abid
authors: A
authors: Assali
authors: Danny
authors: D
authors: Dvir
authors: Hana
authors: H
authors: Vaknin-Assa
authors: Eyal
authors: E
authors: Porat
authors: Yaron
authors: Y
authors: Shapira
authors: Marina
authors: M
authors: Kupershmidt
authors: Tamir
authors: T
authors: Bental
authors: Alexander
authors: A
authors: Battler
authors: Alexander
authors: A
authors: Sagie
authors: Ran
authors: R
authors: Kornowski
mesh_terms: D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D006328:Cardiac Catheterization / Q000379:methods*; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D011474:Prosthesis Design; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome