Transcatheter Aortic Valve Implantation: A Report on Serbia's First Systematic Program

Area of Science:

• Cardiology
• Interventional Cardiology
• Valvular Heart Disease

Background:

• Severe aortic stenosis is a common and serious condition in the elderly.
• Untreated severe aortic stenosis carries a poor prognosis.
• Effective treatment options are crucial for improving patient outcomes.

Purpose of the Study:

• To establish and evaluate the initial outcomes of a transcatheter aortic valve implantation (TAVI) program at the Dedinje Cardiovascular Institute in Serbia.
• To assess the feasibility and safety of TAVI in a cohort of elderly patients with severe aortic stenosis.

Main Methods:

• A systematic TAVI program was implemented, enrolling 56 patients (mean age 74±15 years).
• Patients had a mean logistic EuroScore of 10.17% and STS score of 3.22%, with one-third in NYHA class III/IV.
• Both self-expandable and balloon-expandable valves were used, with selection based on patient-specific factors and team decision.

Main Results:

• The TAVI procedure demonstrated a 100% success rate.
• Trans-femoral access was achieved in all patients (87.5% percutaneous, 12.5% surgical cut-down).
• No moderate/severe aortic regurgitation was observed; 30-day all-cause mortality was 1.78%, with low rates of complications like stroke or pacemaker implantation.

Conclusions:

• The initial TAVI experience at the Dedinje Cardiovascular Institute shows promising and encouraging results.
• These outcomes are comparable to major randomized trials, supporting TAVI as a viable treatment for severe aortic stenosis.
• This success paves the way for the institute to become a high-volume TAVI center.