P690Single-center experience with transcatheter aortic valve implantation and echocardiographic follow-up


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Abstract

Purpose: Transcatheter aortic valve implantation (TAVI) is an emerging new treatment option for patients with symptomatic severe aortic stenosis (AS) and high risk for surgical aortic valve replacement. Since introduction of TAVI into clinical cardiology, echocardiographic data on durability of hemodynamic results is scarce. Hence we analyzed our patient series in this regard with a follow-up period of almost four years.Methods:From May 2007 to May 2011, 180 patients (age: mean 81±6 years, range 62–91 years; male=36%) with severe symptomatic AS and a mean logistic EuroSCORE of 26±15% (range 6–73%) underwent TAVI procedure with the CoreValve prosthesis in our center. All patients had an echocardiographic diagnosed severe aortic stenosis with a mean Peak-Pressure-Gradient (PPG) of 99±28 mmHg, a Mean-Pressure-Gradient (MPG) of 59±16 mmHg, and a mean aortic valve area (AVA) of 0.5±0.1 cm2 before intervention.Echocardiographic parameters were assessed postinterventional and within the follow up visits at 30 days, 3 months, 6 months, and annually after the procedure.Results:Acute procedural success rate was 99.4%. Device implantation resulted in a clear-cut clinical improvement and a significant and sustained reduction of echocardiographic assessed peak and mean transaortic pressure gradients (Fig.1) as well as a significant and sustained increase of calculated aortic valve area.Aortic regurgitation was trivial or mild in 170 patients (94.4%) and moderate in 10 patients (5.6%).Conclusion:Feasibility of TAVI procedure itself has already been proven in numerous cases. Hemodynamic features of the prosthesis, as assessed by echocardiography, yield a beneficial clinical course and remain unchanged up to three years after TAVI. Durability of the haemodynamic results seems to be encouraging.

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