Transaortic transcatheter aortic valve implantation: experience from the Kiel study

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Medical Devices

Background:

• Severe symptomatic aortic stenosis is a significant condition requiring intervention.
• Transcatheter aortic valve implantation (TAVI) has emerged as a crucial treatment option.
• Transaortic (TAo) access is an alternative route for TAVI procedures.

Purpose of the Study:

• To evaluate the efficacy and safety of Edwards SAPIEN-XT and SAPIEN-3 transcatheter heart valves when implanted via the TAo access route.
• To compare procedural and short-term outcomes between SAPIEN-XT and SAPIEN-3 valves in TAo-TAVI.

Main Methods:

• An observational registry included 99 patients undergoing TAo-TAVI with balloon-expandable Sapien valves (SAPIEN-XT or SAPIEN-3).
• Patients received either the SAPIEN-XT (n=53) or SAPIEN-3 (n=46) valve.
• Periprocedural and 30-day post-procedural outcomes were assessed.

Main Results:

• SAPIEN-3 implantation resulted in shorter fluoroscopy times and fewer post-operative dilatations compared to SAPIEN-XT.
• Overall 30-day all-cause mortality was 5.1%, with comparable rates between SAPIEN-XT and SAPIEN-3 valves.
• Common complications included new atrial fibrillation and acute kidney injury; pacemaker implantation rates were low.

Conclusions:

• TAo access with Edwards SAPIEN-XT or SAPIEN-3 valves demonstrates high procedural success and low complication rates.
• This approach is a safe and effective alternative to established TAVI access routes.
• The study supports TAo access as a viable option for TAVI.