Short-term and medium-term outcomes of transapical aortic valve implantation as a single-strategy approach: one center's experience.
BACKGROUND
Transcatheter aortic valve replacement has been developed as an alternative option for surgical high-risk or inoperable patients with severe symptomatic aortic stenosis.


OBJECTIVE
Aim of the study was to evaluate the outcomes of patients undergoing transapical aortic valve replacement as a single-strategy option by a single-center multidisciplinary heart team.


METHODS
Between June 2009 and December 2014, 41 patients underwent transapical transcatheter aortic valve implantation (TA-TAVI) at our institution. All patients received Edwards SAPIEN balloon expandable pericardial valves (Edwards Lifesciences, Irvine, CA, USA). Our center followed a "clear transapical strategy" for all patients.


RESULTS
The mean age of the patients was 79.6 years, and the mean logistic EuroSCORE was 21.06 ± 12.82%. Fifteen patients (36.6%) underwent redo operations. Complications included stroke (n = 1), re-exploration for bleeding or cardiac tamponade (n = 4), renal failure requiring temporary hemodialysis (n = 4) and permanent pacemaker implantation (n = 3). There were no myocardial infarctions or coronary obstruction. The total 30-day mortality rate was 17.1% (7 patients). Postoperative intensive care unit stay was 4.6 ± 5.7 days, and mean hospitalization was 11.6 ± 7.2 days.


CONCLUSIONS
The TA-TAVI approach provides good results in terms of early and midterm outcomes. This approach is feasible and safe for patients who have high surgical risk.
Department of Cardiac Surgery, Hospital České Budějovice, Czech Republic.
Júlia
J
Čanádyová
Department of Cardiac Surgery, Hospital České Budějovice, Czech Republic.
Aleš
A
Mokráček
Department of Cardiology, Hospital České Budějovice, Czech Republic.
Ladislav
L
Pešl
Department of Cardiac Surgery, Hospital České Budějovice, Czech Republic.
Vojtěch
V
Kurfirst
Department of Cardiac Surgery, Hospital České Budějovice, Czech Republic.
Mirek
M
Šulda
aortic stenosis; transapical valve replacement