Efficacy and follow-up of transcatheter aortic valve implantation in patients with radiation-induced aortic stenosis.
To investigate transcatheter aortic valve implantation (TAVI) feasibility, effectiveness and safety in radiation-induced aortic valve stenosis cases.



198 consecutive patients referred for TAVI were prospectively enrolled. They were divided into two groups: patients with a history of chest radiation therapy with suspected radiation-induced valvular disease (RXT) and others with suspected degenerative aortic valve stenosis (NRXT). Procedural, early and mid-term clinical outcomes were compared.



Of the 198 patients enrolled in our study, 9.6% qualified for inclusion in the RXT group. A comparison of baseline characteristics revealed that patients with RXT were younger than patients with NRXT (68.3 vs 82.5 years; p<0.05) and exhibited a lower surgical risk score (Euroscore: 7.1% vs 21.8%; p<0.05) and a higher frequency of hostile thorax and porcelain aorta (52.6% vs 28.5%; p<0.05; 63.2% vs 10.6%; p<0.05, respectively). In both groups, the implantation success rate was high and the 30-day safety end point acceptable (RXT: 94.7% and 83.3%; NRXT: 93.9% and 75.6%, respectively). At 6 months, overall mortality was significantly lower in the RXT group (0% vs 18%; p=0.048).



In patients suffering from radiation-induced aortic valve stenosis and contraindicated for surgery, TAVI is a promising approach, with high feasibility, acceptable risk, low mortality and high clinical effectiveness at mid-term follow-up.
Valvular Disease Department and Echocardiography Laboratory , Haut-Lévêque Bordeaux University Hospital-CIC0005-France , Pessac , France.
Marina
M
Dijos
Valvular Disease Department and Echocardiography Laboratory , Haut-Lévêque Bordeaux University Hospital-CIC0005-France , Pessac , France.
Amélie
A
Reynaud
Valvular Disease Department and Echocardiography Laboratory , Haut-Lévêque Bordeaux University Hospital-CIC0005-France , Pessac , France.
Lionel
L
Leroux
Valvular Disease Department and Echocardiography Laboratory , Haut-Lévêque Bordeaux University Hospital-CIC0005-France , Pessac , France.
Patricia
P
Réant
Valvular Disease Department and Echocardiography Laboratory , Haut-Lévêque Bordeaux University Hospital-CIC0005-France , Pessac , France.
Claire
C
Cornolle
Valvular Disease Department and Echocardiography Laboratory , Haut-Lévêque Bordeaux University Hospital-CIC0005-France , Pessac , France.
Raymond
R
Roudaut
Valvular Disease Department and Echocardiography Laboratory , Haut-Lévêque Bordeaux University Hospital-CIC0005-France , Pessac , France.
Pierre
P
Dos Santos
Valvular Disease Department and Echocardiography Laboratory , Haut-Lévêque Bordeaux University Hospital-CIC0005-France , Pessac , France.
Stéphane
S
Lafitte