P682Transcatheter aortic valve implantation with CoreValve - echocardiographic evaluation of the aortic valve area two years later.

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Purpose: The purpose of the study is to identify whether the immediate increase in the aortic valve area (AVA) of the stenosed tricuspid aortic valve is preserved two years after the transcatheter implantation of the CoreValve.Methods: During 2008, all the patients who have been admitted to the hospital for symptomatic severe aortic valve stenosis and considered to be high risk for surgical aortic valve replacement undergone transcatheter aortic valve implantation (TAVI). Post TAVI the follow-up was performed with transthorasic echo and AVA was calculated with the continuity equation.Results: Twelve patients in total have undergone TAVI with CoreValve revalving system and the six surviving patients had a two year follow-up. AVA before TAVI was 0,59 ± 0,17 cm2, with mean pressure gradient (MPG) 59,5 ± 17,2 mmHg. Three days post TAVI, AVA was 1,23 ± 0,23 cm2 with AVA index (AVA/BSA) 0,73± 0,16 cm2 and MPG 12,1± 4,8 mmHg. During the period of one year post TAVI the AVA and AVA index further increased by 25% and MPG reduced by 31,8%. One year post TAVI, AVA was 1,51±0,29 cm2, with AVA index 0,91± 0,26 cm2 and MPG 8,25 ± 3,60 mmHg (p: 0,07). Paravalvular leakage was reduced by 37,5% (p: 0,04).Two years post TAVI, AVA was 1,44±0,25 cm2 with AVA index 0,84±0,18 cm2 and MPG 8,37± 4 mmHg. It seems that the initial increase in AVA and AVA index is maintained during the second year post TAVI (p: 0,24). Paravalvular leakage two years post TAVI was stable in comparison to the first year (p: 0,31).Conclusions: The immediate result of the transcatheter CoreValve implantation in the position of the stenotic aortic valve is further improved one year after the implantation (further AVA increase and MPG reduction) possibly due to the self-expanding property of the CoreValve and remains stable during the second year.

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