Evaluation of procedural and clinical outcomes of transcatheter aortic valve implantation: A single-center experience

Objective: Transcatheter aortic valve implantation (TAVI) is an established alternative to surgical aortic valve replacement. Our study aimed to evaluate the implementation of TAVI at our large-volume center, having an all-comer patient population with short and long-term follow-ups. Methods: This r...

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Main Authors: Bilge Duran Karaduman, Hüseyin Ayhan, Telat Keleş, Engin Bozkurt
Format: Article
Language:English
Published: KARE Publishing 2020-04-01
Series:Anatolian Journal of Cardiology
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Online Access:https://jag.journalagent.com/z4/download_fulltext.asp?pdir=anatoljcardiol&un=AJC-03942
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author Bilge Duran Karaduman
Hüseyin Ayhan
Telat Keleş
Engin Bozkurt
author_facet Bilge Duran Karaduman
Hüseyin Ayhan
Telat Keleş
Engin Bozkurt
author_sort Bilge Duran Karaduman
collection DOAJ
description Objective: Transcatheter aortic valve implantation (TAVI) is an established alternative to surgical aortic valve replacement. Our study aimed to evaluate the implementation of TAVI at our large-volume center, having an all-comer patient population with short and long-term follow-ups. Methods: This retrospective, single-center analysis included 556 consecutive patients with symptomatic severe aortic stenosis (AS) who underwent TAVI between July 2011 and December 2019. Results: The mean age of the entire population was 77.6+-7.9 years, and 54.9% were women. The Society of Thoracic Surgeons (STS) mean score of the cohort was 6.0%+-3.5%. The balloon-expandable valve (Sapien XT, Sapien 3; Edwards Lifesciences, Irvine, California) was the most frequently used valves in this cohort (94.6%). Transfemoral access was used in 96.3% of patients. Implantation success was achieved in 96.6% of cases. During the TAVI procedure, 7.2% of patients required permanent pacemaker implantation, with 37.5% in the Lotus valve group needing the most permanent pacemakers. The mean length of hospital stay for the entire cohort was 4.5+-2.3 days. Overall, 22 (3.9%) in-hospital deaths occurred before hospital discharge. The mean follow-up period was 15.1+-14.9 months for all patients, and a significant improvement was noted in all echocardiographic parameters and functional capacity. Paravalvular leak (PVL) was documented in 18.9% patients, mild in 17.9%, and moderate in 1% at discharge. No cases with severe PVL, necessitating additional procedures. The multiple logistic regression analysis revealed that sex, STS score, baseline SYNTAX score, bicuspid valve morphology, common femoral artery diameter, and post-TAVI PVL were independent predictors of overall mortality. Conclusion: To our knowledge, this study, which is the largest single-center real-world experience of TAVI in Turkey, demonstrated low complication rates with favorable short- and mid-term THV performance in patients undergoing TAVI. (Anatol J Cardiol 2020; 23: 288-96)
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spelling doaj-art-d98e4916ac924d3b854a27ab8b8470a32025-08-20T02:03:47ZengKARE PublishingAnatolian Journal of Cardiology2149-22632020-04-0123528829610.14744/AnatolJCardiol.2020.03942AJC-03942Evaluation of procedural and clinical outcomes of transcatheter aortic valve implantation: A single-center experienceBilge Duran Karaduman0Hüseyin Ayhan1Telat Keleş2Engin Bozkurt3Department of Cardiology, Faculty of Medicine, Atılım University, Medicana International Ankara Hospital; Ankara-TurkeyDepartment of Cardiology, Faculty of Medicine, Atılım University, Medicana International Ankara Hospital; Ankara-TurkeyDepartment of Cardiology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara City Hospital; Ankara-TurkeyDepartment of Cardiology, Medicana International Ankara Hospital; Ankara-TurkeyObjective: Transcatheter aortic valve implantation (TAVI) is an established alternative to surgical aortic valve replacement. Our study aimed to evaluate the implementation of TAVI at our large-volume center, having an all-comer patient population with short and long-term follow-ups. Methods: This retrospective, single-center analysis included 556 consecutive patients with symptomatic severe aortic stenosis (AS) who underwent TAVI between July 2011 and December 2019. Results: The mean age of the entire population was 77.6+-7.9 years, and 54.9% were women. The Society of Thoracic Surgeons (STS) mean score of the cohort was 6.0%+-3.5%. The balloon-expandable valve (Sapien XT, Sapien 3; Edwards Lifesciences, Irvine, California) was the most frequently used valves in this cohort (94.6%). Transfemoral access was used in 96.3% of patients. Implantation success was achieved in 96.6% of cases. During the TAVI procedure, 7.2% of patients required permanent pacemaker implantation, with 37.5% in the Lotus valve group needing the most permanent pacemakers. The mean length of hospital stay for the entire cohort was 4.5+-2.3 days. Overall, 22 (3.9%) in-hospital deaths occurred before hospital discharge. The mean follow-up period was 15.1+-14.9 months for all patients, and a significant improvement was noted in all echocardiographic parameters and functional capacity. Paravalvular leak (PVL) was documented in 18.9% patients, mild in 17.9%, and moderate in 1% at discharge. No cases with severe PVL, necessitating additional procedures. The multiple logistic regression analysis revealed that sex, STS score, baseline SYNTAX score, bicuspid valve morphology, common femoral artery diameter, and post-TAVI PVL were independent predictors of overall mortality. Conclusion: To our knowledge, this study, which is the largest single-center real-world experience of TAVI in Turkey, demonstrated low complication rates with favorable short- and mid-term THV performance in patients undergoing TAVI. (Anatol J Cardiol 2020; 23: 288-96)https://jag.journalagent.com/z4/download_fulltext.asp?pdir=anatoljcardiol&un=AJC-03942taviaortic stenosissingle-centerclinical outcomes
spellingShingle Bilge Duran Karaduman
Hüseyin Ayhan
Telat Keleş
Engin Bozkurt
Evaluation of procedural and clinical outcomes of transcatheter aortic valve implantation: A single-center experience
Anatolian Journal of Cardiology
tavi
aortic stenosis
single-center
clinical outcomes
title Evaluation of procedural and clinical outcomes of transcatheter aortic valve implantation: A single-center experience
title_full Evaluation of procedural and clinical outcomes of transcatheter aortic valve implantation: A single-center experience
title_fullStr Evaluation of procedural and clinical outcomes of transcatheter aortic valve implantation: A single-center experience
title_full_unstemmed Evaluation of procedural and clinical outcomes of transcatheter aortic valve implantation: A single-center experience
title_short Evaluation of procedural and clinical outcomes of transcatheter aortic valve implantation: A single-center experience
title_sort evaluation of procedural and clinical outcomes of transcatheter aortic valve implantation a single center experience
topic tavi
aortic stenosis
single-center
clinical outcomes
url https://jag.journalagent.com/z4/download_fulltext.asp?pdir=anatoljcardiol&un=AJC-03942
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AT huseyinayhan evaluationofproceduralandclinicaloutcomesoftranscatheteraorticvalveimplantationasinglecenterexperience
AT telatkeles evaluationofproceduralandclinicaloutcomesoftranscatheteraorticvalveimplantationasinglecenterexperience
AT enginbozkurt evaluationofproceduralandclinicaloutcomesoftranscatheteraorticvalveimplantationasinglecenterexperience