Key result
TAVI without routine CT was performed in 384 patients using TTE for annular sizing (73.4%), angiography for iliofemoral assessment (99.5%), and local anaesthesia with or without sedation (85.1%).
Why the study?
Advanced adjunctive technology is used to aid elective TAVI, but extensive pre-procedural work-up may not be possible in an acute setting, motivating an examination of early TAVI practice to inform the concept of primary acute TAVI.
Observational (n=384)
Yes
Retrospective study evaluates procedural characteristics for primary transcatheter aortic valve implantation in 384 patients, indicating the viability of streamlined pre-procedural assessment.
Background: In the elective setting, advanced adjunctive technology is appropriately used to aid TAVI.However, extensive pre-procedural work-up may not be possible in an acute setting.Methods: We examined retrospective data from early TAVI practice to inform the concept of "primary" acute TAVI.Data was examined from two UK TAVI centres (2007-2012) prior to routine use of computerised tomography (CT).30-day and 1 year clinical outcomes were assessed.Mortality tracking was obtained as of December 2012.Results: 384 underwent TAVI at the two sites during this period.Patients were aged 81.4±7.0 years.46.3% were male.Logistic EuroSCORE was 19.2±11.6.Peak aortic valve gradient and aortic valve area were 79.7±25.2mmHgand 0.62±0.20cm2respectively.Aortic annular size was assessed by transthoracic echo (TTE; 73.4%) or transoesophageal echo (TOE; 24.5%) and was 23.1±2.4mm.Iliofemoral assessment was by invasive contrast angiography (99.5%).Procedures were performed under local anaesthetic (39.1%), local anaesthetic and anaesthetic sedation (46.0%), or general anaesthesia (14.9%).Device implantation was predominantly with the CoreValve self-expanding
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Cockburn et al. (2018) conducted an observational in Aortic stenosis undergoing TAVI (n=384). Transcatheter aortic valve implantation (TAVI) without routine CT, TOE, or general anaesthesia was evaluated on 30-day and 1-year clinical outcomes and mortality. TAVI without routine CT was performed in 384 patients using TTE for annular sizing (73.4%), angiography for iliofemoral assessment (99.5%), and local anaesthesia with or without sedation (85.1%).
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