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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
Transapical aortic valve implantation at 3 years
Thomas Walther1, Jörg Kempfert, Ardawan Rastan
1Department of Cardiac Surgery, University Leipzig, Heart Center, Leipzig, Germany. t.walther@kerckhoff-klinik.de
The Journal of Thoracic and Cardiovascular Surgery
|July 5, 2011
Summary
Transapical aortic valve implantation is effective for high-risk aortic stenosis patients. While 10% experienced complications requiring intervention, survival rates remained favorable up to three years.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Medical Devices
Background:
- Aortic stenosis poses significant risks for high-risk surgical candidates.
- Transcatheter aortic valve implantation (TAVI) offers an alternative to conventional surgery.
- Transapical TAVI provides a less invasive approach for selected patient populations.
Purpose of the Study:
- To evaluate the outcomes of transapical aortic valve implantation (TAVI) in high-risk patients with aortic stenosis.
- To analyze survival rates and perioperative complications up to three years post-procedure.
- To assess the impact of a multidisciplinary team approach on TAVI success.
Main Methods:
- A total of 299 high-risk patients with aortic stenosis underwent transapical TAVI using the Edwards SAPIEN xenograft.
- Patients had a mean age of 82 years, with high predicted mortality risks (Logistic EuroSCORE 31%, STS 12%).
- Procedures were conducted in a hybrid operative theater by an integrated team of specialists.
Main Results:
- Successful valve implantation was achieved in all patients.
- 89.3% of procedures were uneventful; 10.7% required additional interventions (e.g., repeat valve, bypass support).
- Survival rates were 91% at 30 days, 73% at 1 year, 68% at 2 years, and 58% at 3 years. Delayed stroke occurred in 0.7%.
Conclusions:
- Transapical TAVI demonstrates good outcomes in high-risk aortic stenosis patients.
- Perioperative complications occur in approximately 10% and necessitate interventions.
- A collaborative, multidisciplinary team approach is crucial for successful transapical TAVI.
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