ICS 2012 Report – Trans-catheter aortic valve implantation: Adverse outcomes of 120 cases in two centres

by Edel O’Connell – Report on poster presented at ICS Annual Meeting

Departments of Cardiology and Cardiothoracics, St James’ University Hospital, Trinity College, Dublin; Blackrock Clinic, Dublin.

Transcatheter aortic valve implantation is an alternative in patients with severe aortic stenosis for whom open surgical valve replacement is not suitable.
In this study, researchers examined mortality in all cases of TAVI to date at two centres.
Patients who underwent TAVI were identified from an institutional registry at the centres.
Periprocedural complications were recorded while mortality at time of clinical follow-up was recorded in both institutions at 30 days, 6 months and one year.
The research found there were 120 cases of TAVI from September 2008 to April 2012.
The mean age was 81.9 years and males accounted for 59 cases, females for 61.
TAVI was performed transfemorally in 104 cases, transapically in 12 and via subclavian in 3 and transaortic in 1.
Femoral access site complications occurred in nine patients (7.5 per cent) of which one required surgical exploration and repair (1.6  per cent). One patient developed aortic dissection during the procedure and one died intraoperatively. Within 30 days of the procedure seven patients died (5.8 per cent). 6 per cent of patients died with 6 months (6 of 100 patients) and 16.4 per cent within 1 year (15 of 91 patients).
The mean age of those who died was 84.3 years.
Only one person had a transient cerebrovascular event at 30 days—none had stroke. One patient had a second TAVI for severe intravalvular and paravalvular aortic regurgitation four months after the initial implant.
The researchers concluded that the overall mortality at 30 days from 120 TAVI procedures was 5.8 %. The mortality at one year from 91 TAVI procedures was 16.4 percent at 1 year. The study’s findings correlate with international experience to date. At 30 days, no patient had stroke.