Publication details

Differences in long-term outcome after femoral, subclavian and aortic approach to transcatheter aortic valve implantation (TAVI)

Authors

BRANNY Marian BRANNY Piotr JANUSKA Jaroslav HUDEC Miroslav KLUZOVA Krystyna KUFOVA Pavla SKNOURIL Libor JARKOVSKÝ Jiří BLAHA Milan KALA Petr

Year of publication 2014
Type Article in Periodical
Magazine / Source Experimental & clinical card
MU Faculty or unit

Faculty of Medicine

Citation
Field Cardiovascular diseases incl. cardiosurgery
Keywords Aortic valve implantation; Transaortic approach; Long-term mortality; TAVI; Aortic stenosis
Description Introduction: Transcatheter aortic valve implantation (TAVI) represents an effective treatment of high-risk patients with severe aortic stenosis. There is no evidence of the long-term outcome of alternative approaches to TAVI. Aim: To asses the clinical outcome after subclavian and aortic TAVI compared to standard femoral approach. Methods: Prospective single-centre study comprise 228 consecutive TAVI patients (average age 79 years, logistic EuroSCORE 17.2, 53.5% females) divided in 1)Femoral, 2)Aortic and 3)Subclavian groups. More peripheral artery disease was found in both Aortic and Subclavian groups. The self-expandable CoreValve (Medtronic Inc., Minneapolis, MN USA) stented prosthesis was exclusively implanted. Results: In 99.6% the valve was successfully deployed. At 30 days the mortality and bleeding occurred in 2.6% and 3.5%, respectively, irrespective of the approach. The long-term major adverse cardiovascular events (MACE)and mortality rate were higher in patients after transaortic TAVI (mortality - 31.3% at 1 year; 65.6% at 2 years in aortic, 14,7%; 24.1% in femoral and 13.1%; 24.7% in subclavian groups, respectively; p=0.043, MACE; p=0.031). Conclusion: Compared to the femoral and subclavian approaches, patients after transaortic TAVI have significantly higher MACE and mortality rate up to 2 years.

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