title: Mid-term results of 150 TAVI comparing apical versus femoral approaches.
abstract: BACKGROUND
  Transcatheter aortic-valve implantation (TAVI) is a new therapeutic choice for treating aortic stenosis in patients considered high risk for surgery. This blooming therapeutic technique still requires evaluation of medium and long term outcome.
  
  
  METHODS
  We hereby report our results of the first 150 consecutive patients to receive TAVI implants in our population recruited from July 2009 to March 2013 in a retrospective and monocentric study. We analyzed long term morbidity and mortality criteria. We compared the apical and femoral approach results and researched predictors of cardiac mortality.
  
  
  RESULTS
  The mean monitoring period was 387.62 days, mean Euroscore was 21.8, and mean Society of Thoracic Surgeons (STS) risk score was 9.2. The success rate for the procedure was 94.6 %. A total of 39 patients died. The mortality rates at the immediate perioperative point, 30 days, 1 year, and 2 years, were 4 %, 11.3 %, 22.7 %, and 26 %, respectively. As regards complications, there were 10 hemodynamic complications (6.6 %) and 20 vascular (13.3 %), 11 cardiac tamponades (7.4 %), eight mechanical (5.3 %), ten major hemorrhagic (6.7 %), 14 pulmonary (9.3 %), and 18 infectious complications (12 %). When comparing the rates of reported complications in terms of different approaches, we observed significantly more hemodynamic complications in the apical group (p = 0.049). Pulmonary complications were also significantly more common in cases of apical approach (p = 0.029). The majority of the patients reported clear functional improvement throughout their follow-up.
  
  
  CONCLUSIONS
  The results of the first 150 patients to receive the implant at the Nancy University Teaching Hospital (CHU Nancy) were consistent with findings in the literature. TAVI proved a credible and effective alternative to surgical valve replacement for patients at high risk during surgery.
authors.affiliation: Service de Cardiologie, CHU de Nancy, Hôpital Brabois, rue du Morvan, F-54511, Vandoeuvre-les-Nancy, France. alain.rouge@hotmail.com.|Université de Lorraine, Nancy, France. alain.rouge@hotmail.com.
authors.forename: Alain
authors.initials: A
authors.lastname: Rougé
authors.affiliation: Service de Cardiologie, CHU de Nancy, Hôpital Brabois, rue du Morvan, F-54511, Vandoeuvre-les-Nancy, France. o.huttin@chu-nancy.fr.|Université de Lorraine, Nancy, France. o.huttin@chu-nancy.fr.
authors.forename: Olivier
authors.initials: O
authors.lastname: Huttin
authors.affiliation: Service de Cardiologie, CHU de Nancy, Hôpital Brabois, rue du Morvan, F-54511, Vandoeuvre-les-Nancy, France. aslam_rumas@hotmail.fr.|Université de Lorraine, Nancy, France. aslam_rumas@hotmail.fr.
authors.forename: Rumas
authors.initials: R
authors.lastname: Aslam
authors.affiliation: Service de Cardiologie, CHU de Nancy, Hôpital Brabois, rue du Morvan, F-54511, Vandoeuvre-les-Nancy, France. tvaugrenard@gmail.com.|Université de Lorraine, Nancy, France. tvaugrenard@gmail.com.
authors.forename: Thibaud
authors.initials: T
authors.lastname: Vaugrenard
authors.affiliation: Service de Néphrologie - CHU Grenoble, Boulevard de la Chantourne, Grenoble, France. tjouve@chu-grenoble.fr.
authors.forename: Thomas
authors.initials: T
authors.lastname: Jouve
authors.affiliation: Service de Cardiologie, CHU de Nancy, Hôpital Brabois, rue du Morvan, F-54511, Vandoeuvre-les-Nancy, France. michaelangioi@gmail.com.|Université de Lorraine, Nancy, France. michaelangioi@gmail.com.
authors.forename: Michael
authors.initials: M
authors.lastname: Angioi
authors.affiliation: Service de Chirurgie Cardiaque, CHU de Nancy, Hôpital Brabois, rue du Morvan, F-54511, Vandoeuvre-les-Nancy, France. jp.maureira@chu-nancy.fr.|Université de Lorraine, Nancy, France. jp.maureira@chu-nancy.fr.
authors.forename: Pablo
authors.initials: P
authors.lastname: Maureira
mesh_terms: D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000601:surgery*; D005260:Female; D005268:Femoral Vein; D005602:France; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D012189:Retrospective Studies; D016019:Survival Analysis; D065467:Transcatheter Aortic Valve Replacement; D016896:Treatment Outcome