title: Transcatheter aortic valve implantation in the presence of hematologic malignancies.
abstract: OBJECTIVE
  Cardiac surgery may be performed in patients with hematologic disorders, but carries an increased risk of morbidity. This series describes an experience of transcatheter aortic valve implantation (TAVI) in patients with hematologic malignancies, and highlights the technical considerations to be kept in mind.
  
  
  METHODS
  Between June 2011 and April 2014, 133 consecutive high-risk patients with symptomatic severe aortic stenosis were treated with TAVI at our centre. Based on consensus among the local heart team, five patients with hematologic malignancies (myelodysplastic syndrome [2],chronic lymphocytic leukemia [2], Hodgkin lymphoma [1]) were considered high risk for surgery (Logistic EUROSCORE 17.2±14.0% and STS score 5.8±4.3%). Serial echocardiographic and clinical follow-ups were done pre- and post-procedure, at discharge, and at 1, 3, 6 and 12 months.
  
  
  RESULTS
  Our procedural success rate was 80%. Two heart valves were implanted in one patient due to aortic embolization of the previous valve. Perforation of the right ventricle and cardiac tamponade occurred in the same patient. Mean blood transfusion requirement was 1.0±1.4 U (range: 0 to 3 U). Mean aortic valve gradient was reduced from baseline to 9.2±3.27 mmHg, and the effective orifice area was significantly increased to 1.96±0.29 cm2. Paravalvular aortic regurgitation (AR) was absent-mild in all the patients.
  
  
  CONCLUSIONS
  This present series demonstrates that TAVI with a balloon-expandable valve can be performed safely and effectively and is technically feasible in high-risk patients with hematologic malignancies.
authors.affiliation: Department of Cardiology, Ataturk Training and Research Hospital, Ankara, Turkey. cengaver61@yahoo.com.
authors.forename: Cenk
authors.initials: C
authors.lastname: Sarı
authors.affiliation: Department of Cardiology, Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey.
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Ayhan
authors.affiliation: Department of Cardiology, Ataturk Training and Research Hospital, Ankara, Turkey.
authors.forename: Serdal
authors.initials: S
authors.lastname: Baştuğ
authors.affiliation: Department of Cardiology, Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey.
authors.forename: Hacı Ahmet
authors.initials: HA
authors.lastname: Kasapkara
authors.affiliation: Department of Cardiology, Ataturk Training and Research Hospital, Ankara, Turkey.
authors.forename: Bilge Duran
authors.initials: BD
authors.lastname: Karaduman
authors.affiliation: Department of Cardiology, Ataturk Training and Research Hospital, Ankara, Turkey.
authors.forename: Abdullah Nabi
authors.initials: AN
authors.lastname: Aslan
authors.affiliation: Department of Cardiology, Ataturk Training and Research Hospital, Ankara, Turkey.
authors.forename: Mehmet Burak
authors.initials: MB
authors.lastname: Özen
authors.affiliation: Department of Cardiology, Ataturk Training and Research Hospital, Ankara, Turkey.
authors.forename: Emine
authors.initials: E
authors.lastname: Bilen
authors.affiliation: Department of Cardiology, Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey.
authors.forename: Nihal Akar
authors.initials: NA
authors.lastname: Bayram
authors.affiliation: Department of Cardiology, Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey.
authors.forename: Telat
authors.initials: T
authors.lastname: Keleş
authors.affiliation: Department of Cardiology, Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey.
authors.forename: Tahir
authors.initials: T
authors.lastname: Durmaz
authors.affiliation: Department of Cardiology, Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey.
authors.forename: Engin
authors.initials: E
authors.lastname: Bozkurt
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D006328:Cardiac Catheterization / Q000379:methods; D004452:Echocardiography; D005260:Female; D019337:Hematologic Neoplasms; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods; D016896:Treatment Outcome