TRANSCATHETER VERSUS SURGICAL AORTIC VALVE REPLACEMENT: FIRST EXPERIENCE WITH A NEW TAVI SYSTEM

The aim: to reveal early results after transapical TAVI with a new self-manufactured XPand system, comparing them with SAVR and common transfemoral TAVI outcomes.

Materials and methods: Eighty-four patients (mean age 79,5±10,2 years) with severe aortic stenosis were operated on from January 2016 to February 2019. Nine patients had undergone the TAVI (two with transfemoral access route and seven with transapical, using the XPand system). SAVR was performed in seventy five patients. For the latter, we estimate the in-hospital mortality, complication rates, intensive care unit and total hospital length of stay.

Results: There was no intraoperative mortality. In the TAVI group, the frequency of intraoperative and postoperative complications was significantly lower (p<0.01). The SAVR group showed higher median intensive care unit length of stay (104 h, IQR 72 -112 versus 29 h, IQR 20-35,p<0.01), hemodynamic support duration (100,98 ± 78 minutes versus 11.13 ± 7.89 minutes, p<0.01) and paravalvular leakage causality (9,33% versus 0%). No significant difference in results depending on the TAVI access routes was obtained.

Conclusions: We conclude that TAVI provides an alternative to the conventional approach in patients with severe aortic stenosis aged over 75 years. No significant difference in mortality rate between TAVI and SAVR groups was found. A novel transapical TAVI device is associated with good short-term results and lower complication rate.