Key result
Balloon-expandable TAVI performed by young cardiologists significantly reduced the mean aortic valve pressure gradient from 48 mmHg to 20 mmHg (p=0.003) at 3 months.
Why the study?
Does balloon-expandable TAVI performed by young interventional cardiologists improve clinical and echocardiographic parameters in high-risk patients with severe aortic stenosis?
Observational (n=11)
No
Does balloon-expandable TAVI performed by young interventional cardiologists improve clinical and echocardiographic parameters in high-risk patients with severe aortic stenosis?
TAVI can be successfully performed by appropriately trained young interventional cardiologists, yielding significant improvements in hemodynamics and functional status.
Answers are grounded in this paper and cite their sources.
May support TAVI feasibility by young cardiologists in one case; hypothesis-generating and should not yet change practice or training.
OBJECTIVE: Surgical aortic valve replacement is the gold standard of treatment for symptomatic severe aortic stenosis in all age groups. Transcatheter aortic valve implantation (TAVI), which is performed by senior interventional cardiologists in experienced centers, is an alternative therapy for patients considered to be at high risk for surgery. The aim of this study is to describe the procedural success and short-term results of TAVI performed by young interventional cardiologists in Trabzon, Turkey. MATERIALS AND METHODS: Eleven patients, 10 women and 1 man, who were treated by balloon-expandable TAVI through transfemoral access between January 2012 and April 2012, were included in the study. The clinical and echocardiographic parameters of the patients were compared before and three months after the procedure. RESULTS: The median calculated logistic EuroSCORE and Society of Thoracic Surgeons (STS) score of patients were 28% (24%-34%) and 14% (12%-18%), respectively. The median age of the patients was 83 years and ranged from 80-85 years. The mean aortic valve pressure gradient and the aortic valve area were significantly improved after TAVI. The mean aortic valve pressure gradient was 48 (46-53) mmHg before treatment and 20 (16-23) mmHg after treatment (p=0.003). The aortic valve area was 0.65 (0.55-0.70) cm(2) before treatment and 1.7 (1.6-1.8) cm(2) after treatment. The functional status of the patients improved from NYHA class 3-4 to NYHA class 1-2. Intraprocedural mortality was not observed, and the overall 3 month mortality was 9%. CONCLUSION: TAVI can be performed successfully by young cardiologists. In centers with high patient loads, we encourage young cardiologists to perform TAVI if they have received the appropriate training and to form specialized, cooperating teams with a focus on TAVI.
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Gökdeniz et al. (2013) conducted an observational in symptomatic severe aortic stenosis (n=11). Balloon-expandable Transcatheter Aortic Valve Implantation (TAVI) vs. Baseline (before treatment) was evaluated on mean aortic valve pressure gradient (p=0.003). Balloon-expandable TAVI performed by young cardiologists significantly reduced the mean aortic valve pressure gradient from 48 mmHg to 20 mmHg (p=0.003) at 3 months.
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