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Published on: December 11, 2017
Transapical aortic valve implantation - an Australian experience
Michael Seco1, Gonzalo Martinez2, Paul G Bannon1
1Sydney Medical School, The University of Sydney, Sydney, Australia; The Baird Institute of Applied Heart and Lung Surgical Research, Sydney, Australia; Cardiothoracic Surgical Unit, Royal Prince Alfred Hospital, Sydney, Australia.
Transcatheter aortic valve implantation (TAVI) via the transapical approach shows good short-term outcomes in Australian patients. This minimally invasive procedure for severe aortic stenosis achieved low mortality and complication rates.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Surgery
Background:
- Severe symptomatic aortic stenosis requires intervention.
- Transcatheter aortic valve implantation (TAVI) offers a minimally invasive alternative to surgical valve replacement.
- The transapical approach is one method for TAVI delivery.
Purpose of the Study:
- To report the initial experience with transapical TAVI at an Australian institution.
- To evaluate the safety and efficacy of the transapical TAVI approach.
Main Methods:
- Prospective data collection for 32 patients with severe aortic stenosis undergoing transapical TAVI with Edwards SAPIEN prosthesis.
- Assessment by a multidisciplinary team.
- Analysis according to Valve Academic Research Consortium version 2 guidelines.
Main Results:
- 100% device success with no conversion to surgery.
- At 30 days: no mortality, low rates of myocardial infarction (3.1%), stroke (3.1%), and major bleeding (15.6%).
- At mean follow-up of 28.8 months: 9.4% mortality, 6.3% stroke, and no repeat procedures. Mild paravalvular regurgitation in 29%.
Conclusions:
- Transapical TAVI is a viable option for severe aortic stenosis in Australia.
- The procedure demonstrates good short-term outcomes with low mortality and complication rates.
- Effective prosthesis function was maintained at one year post-procedure.
