[Experience of transcatheter aortic valve implantation in the Central Military Hospital]

Transcatheter aortic valve implantation (TAVI) is an alternative treatment for patients with severe symptomatic aortic stenosis, inoperable or at high surgical risk. The purpose of this communication is to report the results of the experience of this new technique and compare them with literature.

Review of 17 patients data with symptomatic severe aortic stenosis at high surgical risk or inoperable, treated with a transcatheter implantation aortic valve (TAVI) via femoral surgical access with Core Valve (Medtronic, EE.UU.) between September 2013 and July 2014.

All patients had severe aortic stenosis with a mean gradient of 46̊æ14 mmHg received CoreValveTM (Medtronic, USA). Half of patients was performed under general anesthesia, the other half with regional and local anesthesia. In-hospital mortality was 11.7% and one death in follow-up from September 2013 until the time of preparing this report (5.9%).Total mortality at one year follow-up was 17.6%. The technical success rate was 82.4%, with an immediate post-implantation gradient of 5.4̊æ3.4 mmHg. Aortic regurgitation I degree was observed in 5 patients (29.4%); 2 patients (11.7%) had aortic regurgitation grade II. Post dilatation was made in 6 patients (35.2%). We did not have any vascular complications. Permanent pacemaker implantation was needed in 6 patients (35.2%). One patient complicated with acute renal failure, 2 had in-hospital ischemic stroke (11.7%), none had need for cardiac surgery; 2 patients had major bleeding complications that required transfusion.

In patients with high surgical risk or inoperable, TAVI is a treatment option that improves life quality, survival and diminsh the need of hospitalizations. There can be some complications and even death, so that a proper patient selection and a multidisciplinary team is needed and fundamental for a successful procedure.