Transapical aortic valve implantation-an Australian experience

Michael Seco, Gonzalo Martinez, Paul G. Bannon, Bruce L. Cartwright, Mark Adams, Martin Ng, Michael K. Wilson, Michael P. Vallely*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)

Abstract

Background: The aim of this study was to report our initial experience with the transapical approach to transcatheter aortic valve implantation (TAVI) at an Australian institution. Methods: All patients with severe, symptomatic aortic stenosis were assessed by our multidisciplinary team. A total of 32 patients received a transapical TAVI using an Edwards SAPIEN prosthesis. Data were prospectively collected and analysed according to the Valve Academic Research Consortium version 2 guidelines. Results: Intraoperative outcomes included: 100% device success with no conversion to surgical valve replacement, extracorporeal membrane oxygenation was used electively in 15.6% and emergently in 6.3%, and no valve migration or malpositioning requiring prosthesis retrieval and re-implantation.Outcomes at 30 days post-TAVI included: No mortality, 3.1% myocardial infarction, no disabling stroke, 3.1% non-disabling stroke, no transient ischaemic attacks, 6.3% life-threatening bleeding, 15.6% major bleeding, 3.1% major vascular complications, and 12.5% postoperative acute kidney injury requiring renal replacement therapy. Mild paravalvular regurgitation was present in 29%, and there was no moderate or severe regurgitation.Mean follow-up time was 28.8±12.9 months. Cumulative results included: 9.4% mortality, 6.3% stroke, 6.3% myocardial infarction, and no repeat procedures. At one year postoperation, echocardiography demonstrated that the mean pressure across the prosthesis was 10.1±1.7mmHg, and the mean aortic valve area was 1.4±0.2cm2. Conclusion: Good short-term outcomes and low or zero mortality are achievable with transapical TAVI at an Australian institution.

Original languageEnglish
Pages (from-to)462-468
Number of pages7
JournalHeart, Lung and Circulation
Volume23
Issue number5
DOIs
Publication statusPublished - May 2014

Keywords

  • transapical
  • transcatheter aortic valve implantation
  • heart valve prosthesis
  • aortic valve stenosis

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