Transcatheter aortic valve implantation for bicuspid aortic valve stenosis: Acute and intermediate-term outcomes in a high volume institution

Authors

  • Anže Djordjević University Clinical Center Maribor, Maribor, Slovenia
  • Giuseppe D'Ancona Department of Cardiology, Vivantes Klinikum im Friedrichshain und Am Urban, Berlin, Germany, and Rostock University Medical Center, Rostock, Germany
  • Axel Unbehaun Department of Cardiac Surgery, Deutsches Herzzentrum Berlin, Berlin, Germany
  • Stephan Kische Department of Cardiology, Vivantes Klinikum im Friedrichshain und Am Urban, Berlin, Germany, and Rostock University Medical Center, Rostock, Germany
  • Hüseyin Ince Department of Cardiology, Vivantes Klinikum im Friedrichshain und Am Urban, Berlin, Germany, and Rostock University Medical Center, Rostock, Germany
  • Miralem Pašić Department of Cardiac Surgery, Deutsches Herzzentrum Berlin, Berlin, Germany

DOI:

https://doi.org/10.6016/ZdravVestn.2175

Keywords:

TAVi, bicuspid, aortic, valve

Abstract

Background: We report our experience with transcatheter aortic valve implantation (TAVI) in patients with bicuspid aortic valve (BAV) stenosis.

Methods: Perioperative and intermediate-term follow-up data were retrospectively analysed. All procedures were performed within the premises of an experienced high-volume TAVI centre.

Results: Tirty-three consecutive BAV patients (age 55 to 87 years) underwent TAVI. Mean logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE) was 23,2 ± 19,3. Transapical Edwards Sapien® valve was implanted in the majority of patients (87.9 %). Nine patients (27.3 %) required post-ballooning of the implanted valve for moderate to severe paravalvular leak, 3 patients (9 %) required a second valve implantation for persistent severe paravalvular leak, and 2 (6 %) required conversion to conventional surgery. Post-operative mild aortic regurgitation (AR) was presented in 12 patients (36.4%) and AR = 2 in 3 %. No AR > 2 was observed. Te device success rate according to the valve academic research consortium (VARC) criteria was 82 %. Similar BAV anatomy, calcium distribution, type and size of implanted valve were noticed in patients with and without residual AR. Tere was no thirty-day mortality. Two-year estimated survival was 70 % (CI: 52.7–93.1) and was similar in patients with and without post-procedural residual paravalvular leak.

Conclusions: TAVI in BAV stenosis is feasible but, even in experienced centres, is technically more challenging and is associated with a higher rate of post-dilatation, re-valving, and conversion to conventional surgery. Results should be re-tested in light of the recent introduction of second-generation TAVI prostheses.

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References

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Published

2017-03-01

Issue

Vol. 86 No. 1-2 (2017): January-February

Section

Original article

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How to Cite

1.
Transcatheter aortic valve implantation for bicuspid aortic valve stenosis: Acute and intermediate-term outcomes in a high volume institution. ZdravVestn [Internet]. 2017 Mar. 1 [cited 2024 Nov. 2];86(1-2):8-18. Available from: https://vestnik.szd.si/index.php/ZdravVest/article/view/2175

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