Colombian experience with transcatheter aortic valve implantation of medtronic corevalve

Antonio E. Dager, Rutger Jan Nuis, Bernardo Caicedo, Jaime A. Fonseca, Camilo Arana, Lidsa R.N. Cruz, Luis M. Benitez, Carlos A. Nader, Eduardo Duenas, Eduardo J. de Marchena, William W. O'Neill, Peter P. de Jaegere

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

At our institutions, increasing numbers of aortic stenosis patients were not candidates for surgical aortic valve replacement. Accordingly, we initiated the Cali Colombian Transcatheter Aortic Valve Implantation (TAVI) program. From March 2008 through January 2011, 53 consecutive patients (mean age, 79 ± 6 yr; men, 58%) underwent TAVI with the Medtronic CoreValve System, and data were prospectively collected. Our study's endpoints conformed with Valve Academic Research Consortium recommendations. We report our clinical results. Predicted mortality rates were 25% (interquartile range, 17%-34%) according to logistic EuroSCORE and 6% (interquartile range, 3%-8%) according to the Society of Thoracic Surgeons score. The 30-day mortality rate was 9% (3 intraprocedural deaths, 5 total). The combined 30-day safety endpoint was 30% (major vascular sequelae, 23%; life-threatening bleeding, 12%; myocardial infarction, 4%; major stroke, 4%; and acute kidney injury [stage 3], 2%). Eight patients (15%) required post-implantation balloon dilation and 2 (4%) required valve-in-valve implantation, for a technical device success rate of 77%. Mean peak transvalvular gradient decreased from 74 ± 29 to 17 ± 8 mmHg and mean transvalvular gradient from 40 ± 17 to 8 ± 4 mmHg (both P=0.001). Moderate or severe aortic regurgitation decreased from 32% to 18% (P=0.12) and mitral regurgitation from 32% to 13% (P=0.002). The 1-year survival rate was 81%. We found that TAVI with the CoreValve prosthesis was safe and feasible, with sustained long-term results, for treating aortic stenosis in patients at excessive surgical risk; nonetheless, serious adverse events occurred in 30% of the patients.

Original languageEnglish (US)
Pages (from-to)351-358
Number of pages8
JournalTexas Heart Institute Journal
Volume39
Issue number3
StatePublished - Jul 26 2012

Keywords

  • Aortic valve stenosis/complications/mortality/surgery
  • Comorbidity
  • Heart valve prosthesis implantation/methods
  • Postoperative complications/etiology/prevention control
  • Registries
  • Risk factors
  • Treatment outcome

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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  • Cite this

    Dager, A. E., Nuis, R. J., Caicedo, B., Fonseca, J. A., Arana, C., Cruz, L. R. N., Benitez, L. M., Nader, C. A., Duenas, E., de Marchena, E. J., O'Neill, W. W., & de Jaegere, P. P. (2012). Colombian experience with transcatheter aortic valve implantation of medtronic corevalve. Texas Heart Institute Journal, 39(3), 351-358.