One-year results of transcatheter aortic valve implantation as an alternative treatment for severe aortic stenosis in high-risk patients

Yu Ting Yuan, Ying Hwa Chen, Po Lin Chen, Han Chin Tsai, I. Ming Chen, Zen Chung Weng, Chun Che Shih, Hsiao Huang Chang

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Aortic valve replacement (AVR) remains the gold standard treatment for symptomatic severe aortic stenosis (AS). For the past 10years, transcatheter aortic valve implantation (TAVI) has been applied in patients with high surgical mortality and morbidity risks. The preliminary results of our TAVI patients are presented in this study. Methods: Ten high-risk patients with severe AS, for AVR, were referred and accepted for TAVI in the 6 month period from May 2010 to October 2010. The patient age, logistic EuroSCORE, femoral arterial diameter, aorta annulus size, aorta valve area (AVA), mean aortic pressure gradient (MPG), as well as coronary angiography results were all collected. Six patients were treated via the transapical approach in March 2010, whereas the other four were treated with the transfemoral approach, according to their femoral artery diameter and arterial quality. This study focuses on the immediate, 1 month, 3 month, and 1 year results of TAVI. Results: The average age of the 10 patients receiving TAVI was 81.5 years. The mean calculated EuroSCORE was 28.3±7.9%. The mean AVA was 0.61±0.19cm2. The MPG was 48±16mmHg. The surgical technical success achieved 100%. There was no reported moderate to severe postoperative paravalvular aortic regurgitation, permanent complete atrioventricular block, major access site complication, or embolic stroke. Chronic renal failure, which necessitated permanent hemodialysis, developed in 10% of the patients. One acute myocardial infarction and one case of pneumonia developed postoperatively. The AVA was increased by 251%, whereas the MPG was decreased by 80% at the 3 month follow-up. The 30-day mortality rate was 10%. The all-cause 1-year mortality rate was 20%. Conclusion: This new technique and device requires greater caution and needs more practice to accumulate sufficient experience. The studied patients were very fragile, due to old age and multiple comorbidities. Our results are similar to findings of multicenter trials. With careful patient screening and selection, TAVI can be a promising treatment for high-risk severe AS patients.

Original languageEnglish
Pages (from-to)698-702
Number of pages5
JournalJournal of the Chinese Medical Association
Volume76
Issue number12
DOIs
Publication statusPublished - Dec 2013

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Aortic Valve Stenosis
Aorta
Arterial Pressure
Therapeutics
Aortic Valve
Mortality
Transcatheter Aortic Valve Replacement
Aortic Valve Insufficiency
Atrioventricular Block
Femoral Artery
Thigh
Coronary Angiography
Patient Selection
Multicenter Studies
Chronic Kidney Failure
Renal Dialysis
Comorbidity
Pneumonia
Stroke
Myocardial Infarction

Keywords

  • Aortic stenosis
  • Aortic valve replacement
  • TAVI
  • Transcatheter aortic valve implantation

ASJC Scopus subject areas

  • Medicine(all)

Cite this

One-year results of transcatheter aortic valve implantation as an alternative treatment for severe aortic stenosis in high-risk patients. / Yuan, Yu Ting; Chen, Ying Hwa; Chen, Po Lin; Tsai, Han Chin; Chen, I. Ming; Weng, Zen Chung; Shih, Chun Che; Chang, Hsiao Huang.

In: Journal of the Chinese Medical Association, Vol. 76, No. 12, 12.2013, p. 698-702.

Research output: Contribution to journalArticle

Yuan, Yu Ting ; Chen, Ying Hwa ; Chen, Po Lin ; Tsai, Han Chin ; Chen, I. Ming ; Weng, Zen Chung ; Shih, Chun Che ; Chang, Hsiao Huang. / One-year results of transcatheter aortic valve implantation as an alternative treatment for severe aortic stenosis in high-risk patients. In: Journal of the Chinese Medical Association. 2013 ; Vol. 76, No. 12. pp. 698-702.
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abstract = "Background: Aortic valve replacement (AVR) remains the gold standard treatment for symptomatic severe aortic stenosis (AS). For the past 10years, transcatheter aortic valve implantation (TAVI) has been applied in patients with high surgical mortality and morbidity risks. The preliminary results of our TAVI patients are presented in this study. Methods: Ten high-risk patients with severe AS, for AVR, were referred and accepted for TAVI in the 6 month period from May 2010 to October 2010. The patient age, logistic EuroSCORE, femoral arterial diameter, aorta annulus size, aorta valve area (AVA), mean aortic pressure gradient (MPG), as well as coronary angiography results were all collected. Six patients were treated via the transapical approach in March 2010, whereas the other four were treated with the transfemoral approach, according to their femoral artery diameter and arterial quality. This study focuses on the immediate, 1 month, 3 month, and 1 year results of TAVI. Results: The average age of the 10 patients receiving TAVI was 81.5 years. The mean calculated EuroSCORE was 28.3±7.9{\%}. The mean AVA was 0.61±0.19cm2. The MPG was 48±16mmHg. The surgical technical success achieved 100{\%}. There was no reported moderate to severe postoperative paravalvular aortic regurgitation, permanent complete atrioventricular block, major access site complication, or embolic stroke. Chronic renal failure, which necessitated permanent hemodialysis, developed in 10{\%} of the patients. One acute myocardial infarction and one case of pneumonia developed postoperatively. The AVA was increased by 251{\%}, whereas the MPG was decreased by 80{\%} at the 3 month follow-up. The 30-day mortality rate was 10{\%}. The all-cause 1-year mortality rate was 20{\%}. Conclusion: This new technique and device requires greater caution and needs more practice to accumulate sufficient experience. The studied patients were very fragile, due to old age and multiple comorbidities. Our results are similar to findings of multicenter trials. With careful patient screening and selection, TAVI can be a promising treatment for high-risk severe AS patients.",
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AU - Yuan, Yu Ting

AU - Chen, Ying Hwa

AU - Chen, Po Lin

AU - Tsai, Han Chin

AU - Chen, I. Ming

AU - Weng, Zen Chung

AU - Shih, Chun Che

AU - Chang, Hsiao Huang

PY - 2013/12

Y1 - 2013/12

N2 - Background: Aortic valve replacement (AVR) remains the gold standard treatment for symptomatic severe aortic stenosis (AS). For the past 10years, transcatheter aortic valve implantation (TAVI) has been applied in patients with high surgical mortality and morbidity risks. The preliminary results of our TAVI patients are presented in this study. Methods: Ten high-risk patients with severe AS, for AVR, were referred and accepted for TAVI in the 6 month period from May 2010 to October 2010. The patient age, logistic EuroSCORE, femoral arterial diameter, aorta annulus size, aorta valve area (AVA), mean aortic pressure gradient (MPG), as well as coronary angiography results were all collected. Six patients were treated via the transapical approach in March 2010, whereas the other four were treated with the transfemoral approach, according to their femoral artery diameter and arterial quality. This study focuses on the immediate, 1 month, 3 month, and 1 year results of TAVI. Results: The average age of the 10 patients receiving TAVI was 81.5 years. The mean calculated EuroSCORE was 28.3±7.9%. The mean AVA was 0.61±0.19cm2. The MPG was 48±16mmHg. The surgical technical success achieved 100%. There was no reported moderate to severe postoperative paravalvular aortic regurgitation, permanent complete atrioventricular block, major access site complication, or embolic stroke. Chronic renal failure, which necessitated permanent hemodialysis, developed in 10% of the patients. One acute myocardial infarction and one case of pneumonia developed postoperatively. The AVA was increased by 251%, whereas the MPG was decreased by 80% at the 3 month follow-up. The 30-day mortality rate was 10%. The all-cause 1-year mortality rate was 20%. Conclusion: This new technique and device requires greater caution and needs more practice to accumulate sufficient experience. The studied patients were very fragile, due to old age and multiple comorbidities. Our results are similar to findings of multicenter trials. With careful patient screening and selection, TAVI can be a promising treatment for high-risk severe AS patients.

AB - Background: Aortic valve replacement (AVR) remains the gold standard treatment for symptomatic severe aortic stenosis (AS). For the past 10years, transcatheter aortic valve implantation (TAVI) has been applied in patients with high surgical mortality and morbidity risks. The preliminary results of our TAVI patients are presented in this study. Methods: Ten high-risk patients with severe AS, for AVR, were referred and accepted for TAVI in the 6 month period from May 2010 to October 2010. The patient age, logistic EuroSCORE, femoral arterial diameter, aorta annulus size, aorta valve area (AVA), mean aortic pressure gradient (MPG), as well as coronary angiography results were all collected. Six patients were treated via the transapical approach in March 2010, whereas the other four were treated with the transfemoral approach, according to their femoral artery diameter and arterial quality. This study focuses on the immediate, 1 month, 3 month, and 1 year results of TAVI. Results: The average age of the 10 patients receiving TAVI was 81.5 years. The mean calculated EuroSCORE was 28.3±7.9%. The mean AVA was 0.61±0.19cm2. The MPG was 48±16mmHg. The surgical technical success achieved 100%. There was no reported moderate to severe postoperative paravalvular aortic regurgitation, permanent complete atrioventricular block, major access site complication, or embolic stroke. Chronic renal failure, which necessitated permanent hemodialysis, developed in 10% of the patients. One acute myocardial infarction and one case of pneumonia developed postoperatively. The AVA was increased by 251%, whereas the MPG was decreased by 80% at the 3 month follow-up. The 30-day mortality rate was 10%. The all-cause 1-year mortality rate was 20%. Conclusion: This new technique and device requires greater caution and needs more practice to accumulate sufficient experience. The studied patients were very fragile, due to old age and multiple comorbidities. Our results are similar to findings of multicenter trials. With careful patient screening and selection, TAVI can be a promising treatment for high-risk severe AS patients.

KW - Aortic stenosis

KW - Aortic valve replacement

KW - TAVI

KW - Transcatheter aortic valve implantation

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