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Aortic valve surgery is the standart therapy of symptomatic severe aortic stenosis (AS). But Transcatheter Aortic Valve Implantation (TAVI) has been a recently established treatment for the patients inoperable or high risk for valve surgery. In Europe and in our clinic two of the devices mostly used for TAVI are Edwards SAPIEN (Edwards Lifesciences, Irvine, CA) and CoreValve System (Medtronic Inc., Minneapolis, MN). The aim of this study is presenting the short term effects of TAVI on echocardiographic outcomes.
The short term postprocedural echocardiographic parameters of 36 patients who underwent TAVI in our clinic between 01 June 2012 and 31 May 2013 were studied. Edwards Sapien or CoreValve bioprotesis valves implanted to all of the patients by transfemoral approach (by surgical cut down or percutaneously). Echocardiographic parameters of the baseline and 1 month after the procedure were compared.
Procedural succes rate was %100 (36/36). The mean age of the patients was 78.5±7.6. Twenty (55,6%) of the patients were female. The Logistic EuroScore was 36.4±14.3 (Table 1). Twenty six (72%) of the patients had been implanted with Corevalve, 2 patients needed second valve because of valve dislodgement. When compared with preprocedural results, left ventricular ejection fraction (LVEF), maximal and mean aortic gradients, and pulmonary arterial pressures (PAP) after TAVI were reduced significantly; in addition to these, the degree of mitral and aortic regurgitations were also significantly reduced after TAVI (Table 2).
TAVI has been a reliable treatment to high risk patients for aortic valve surgery with low incidence of complications, and high success rates. Our study demonstrated that the echocardiographic parameters improved significantly after TAVI in a one month period, however, these changes seems to be changed independently from the type of the devices.
|Age (years)||78,5 ± 7,6|
|Sex (M)||16 (44,4)|
|HT (%)||30 (83,3)|
|DM (%)||9 (25)|
|COPD (%)||18 (50)|
|PVD (%)||11 (30,6)|
|CABG (%)||9 (25)|
|Logistic Euroscore||36,4 ± 14,3|
|Euroscore II||10,2 ± 6,0|
|STS score||7,9 ± 6,2|
HT=Hypertension; DM=Diabetes Mellitus; COPD=Chronic Obstructive Pulmonary Disease; PVD=Peripheral Vascular Disease; CABG=Coronary Artery Bypass Greft
|Peak AV gradient (mm Hg)||75,7±14,3||17,2±6,6||<0.001|
|Mean AV gradient (mm Hg)||49,3±8,8||8,6±3,6||<0.001|
|PAP (mm Hg)||44,9±12,6||34,9±11,5||<0.001|
LVEF=Left Ventricular Ejection Fraction, LVESD= Left Ventricular End Systolic Diameter; LVEDD= Left Ventricular End Diastolic Diameter; IVS= Interventricular Septum; AV=Aortic Valve; PAP=Pulmonary Arterial Pressure; MR=Mitral Regurgitation; AR=Aortic Regurgitation