Objective Heart valve replacement in inoperable or high-risk patient changed dramatically after publication of PARTNER trial’s results in 2011 (1). Our aim is to report and investigate our Heart-Team`s experience in transcatheter heart valve prosthesis implantation (THVI) over 7 years after the first 800 procedures. Methods We retrospectively analyzed all THVI occurred in our institute starting from July 2009 up to April 2017. Clinical data were retrieved from medical records. The postoperative outcome was measured and reported according to VARC-2 criteria (2). Results 805 procedures in 802 patients (age 81,67±6,07 years; range 52-94 years) were performed in study period. Of these, 9 prostheses were implanted in mitral position (TMVI through an transapical approach) and 796 in aortic position (TAVI). The overall immediate procedural mortality was 1,47%. Logistic Euroscore, Euroscore II, 30-day mortality, access related-complications and stoke are showed separately for the two groups (trans-femoral or TF, trans-apical or TA) in Table 1. The preoperative mortality risk decreased progressively in TF group so as increased in TA. The 30-day mortality was always lower than logistic Euroscore. The major access related complications for all procedures showed a progressively and remarkable reduction in both groups. The incidence of stroke was lower in TA group. Conclusions THVI is a reliable procedure. Over the years a shift of high-risk patients towards TA approach was observed. On the other hands the TF approach showed a trend towards intermediate risk. Data suggests that more and more patients could take advantage of it. Specific, procedure related complications are one drawback of the technology and need to be addressed in the future.
Posterpreis für seinen wissenschaftlichen Beitrag am Paracelsus Science Get Together 2017 / Pollari, Francesco; Söhn, Claudius; Marianowicz, Jill; Wiehofsky, Pia; Vogt, Ferdinand; Eckner, Dennis; Schwab, Johannes; Jessl, Jürgen; Pauschinger, Matthias; Fischlein, Theodor; Pfeiffer, Steffen. - (2017).
Posterpreis für seinen wissenschaftlichen Beitrag am Paracelsus Science Get Together 2017
Francesco Pollari
Writing – Original Draft Preparation
;
2017
Abstract
Objective Heart valve replacement in inoperable or high-risk patient changed dramatically after publication of PARTNER trial’s results in 2011 (1). Our aim is to report and investigate our Heart-Team`s experience in transcatheter heart valve prosthesis implantation (THVI) over 7 years after the first 800 procedures. Methods We retrospectively analyzed all THVI occurred in our institute starting from July 2009 up to April 2017. Clinical data were retrieved from medical records. The postoperative outcome was measured and reported according to VARC-2 criteria (2). Results 805 procedures in 802 patients (age 81,67±6,07 years; range 52-94 years) were performed in study period. Of these, 9 prostheses were implanted in mitral position (TMVI through an transapical approach) and 796 in aortic position (TAVI). The overall immediate procedural mortality was 1,47%. Logistic Euroscore, Euroscore II, 30-day mortality, access related-complications and stoke are showed separately for the two groups (trans-femoral or TF, trans-apical or TA) in Table 1. The preoperative mortality risk decreased progressively in TF group so as increased in TA. The 30-day mortality was always lower than logistic Euroscore. The major access related complications for all procedures showed a progressively and remarkable reduction in both groups. The incidence of stroke was lower in TA group. Conclusions THVI is a reliable procedure. Over the years a shift of high-risk patients towards TA approach was observed. On the other hands the TF approach showed a trend towards intermediate risk. Data suggests that more and more patients could take advantage of it. Specific, procedure related complications are one drawback of the technology and need to be addressed in the future.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
