Percutaneous aortic valve implantation
Caeiro, D.; Fontes-Carvalho, R.; Lima, R.; Melica, B.; Santos, L.; Rodrigues, A.; Braga, P.; Gonçalves, M.; Albuquerque, A.íb.; Gama, V.
Revista Portuguesa de Cardiologia Orgao Oficial da Sociedade Portuguesa de Cardiologia 29(11): 1699-1712
2010
ISSN/ISBN: 0870-2551 PMID: 21309359 Document Number: 640089
Percutaneous aortic valve implantation is an emerging procedure for the treatment of patients with severe aortic stenosis. The procedure was performed in patients with severe symptomatic aortic stenosis, who had been refused for aortic valve replacement surgery. A self-expanding bioprosthesis within a nitinol frame delivered by an 18F catheter was used. Most of the procedures were performed through a femoral artery approach and under local anesthesia and sedation. Thirty-two patients were treated, mean age 80 years, with various comorbidities and mean logistic EuroSCORE of 22%. The procedure was successful in all patients, with a significant improvement in transvalvular gradients. Two patients died due to procedure-related complications. The most common complications were vascular access related and high-degree atrioventricular block requiring permanent pacemaker. No events were reported after one month follow-up, with most patients showing improvement in functional capacity. After 23 months of follow-up (mean 13 months) five additional deaths had occurred. No prosthesis-related events were observed. Percutaneous aortic valve implantation is safe and improves quality of life in patients with severe symptomatic aortic stenosis. It may be an alternative therapeutic option for patients with high risk features for aortic replacement surgery.