Initial experience of two national centers in transcatheter aortic prosthesis implantation.
BACKGROUND
Transcatheter aortic valve implantation is an effective alternative to surgical treatment of severe aortic stenosis in patients who are inoperable or at high surgical risk.


OBJECTIVE
To report the immediate and follow-up clinical and echocardiographic results of the initial experience of transcatheter aortic valve implantation.


METHODS
From 2009 June to 2013 February, 112 patients underwent transcatheter aortic valve implantation.


RESULTS
Mean age was 82.5 ± 6.5 years, and the logistic EuroSCORE was 23.6 ± 13.5. Procedural success was 84%. After the intervention, a reduction in the mean systolic gradient was observed (pre: 54.7 ± 15.3 vs. post: 11.7 ± 4.0 mmHg; p < 0.01). Cerebrovascular accidents occurred in 3.6%, vascular complications in 19% and permanent pacemaker was required by 13% of the patients. Thirty-day mortality and at follow-up of 16 ± 11 months was 14% and 8.9% respectively. The presence of chronic obstructive pulmonary disease was the only predictor of mortality at 30 days and at follow-up. During follow up, aortic valve area and mean systolic gradient did not change significantly.


CONCLUSIONS
Transcatheter aortic valve implantation is an effective and safe procedure for the treatment of aortic stenosis in high-surgical risk or inoperable patients. The presence of chronic obstructive pulmonary disease was the only independent predictor of mortality identified both in the first month post-intervention and at follow-up.
Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brasil.
Sebastián
S
Lluberas
Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brasil.
Alexandre
A
Abizaid
Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brasil.
Dimytri
D
Siqueira
Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brasil.
Auristela
A
Ramos
Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brasil.
J Ribamar
JR
Costa
Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brasil.
Magaly
M
Arrais
Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brasil.
Antônio
A
Kambara
Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brasil.
David Le
DL
Bihan
Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brasil.
Amanda
A
Sousa
Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brasil.
J Eduardo
JE
Sousa
D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D006439:Hemodynamics; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D011183:Postoperative Complications; D018570:Risk Assessment; D012307:Risk Factors; D018709:Statistics, Nonparametric; D020521:Stroke / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome