Key result
Direct implantation of the CoreValve prosthesis in patients with severe aortic stenosis and high surgical risk achieved a 95% procedural success rate and 75% cumulative survival at 5 months.
Why the study?
Is direct implantation of a self-expanding aortic valve prosthesis safe and feasible in patients with severe aortic stenosis and high surgical risk?
Observational (n=21)
No
Is direct implantation of a self-expanding aortic valve prosthesis safe and feasible in patients with severe aortic stenosis and high surgical risk?
Direct implantation of a self-expanding aortic valve prosthesis is a feasible and effective option for high-surgical-risk patients with severe aortic stenosis, though it carries a notable risk of atrioventricular block requiring pacing.
Answers are grounded in this paper and cite their sources.
Supports feasibility of direct implantation in high-risk aortic stenosis; hypothesis-generating and requires prospective trials before practice change.
Objective To describe the initial experience with aortic valve implantation via a direct approach using a self-expanding CoreValve TM aortic valve prosthesis in a tertiary care center from Argentina. Material and methods From May to December 2010, 21 consecutive patients with severe aortic stenosis (SAS) and high surgical risk undergoing percutaneous aortic valve replacement with CoreValve TM prosthesis were included. The inclusion criteria were the following: aortic valve area 6 mm. Results Mean age was 79±8 years, mean aortic valve area was 0.7±0.2 cm 2 and mean logistic EuroSCORE was 26±15% (50% with logistic EuroSCORE ³ 20%). After valve implantation, peak transaortic pressure gradient measured by echocardiography decreased from 80±22 to 14±5 mm Hg. Two patients developed severe aortic regurgitation which improved with post-dilation. The success rate of the procedure was of 95% as a patient died immediately after valve implant. A definite pacemaker was implanted to six patients due to atrioventricular block. Cumulative survival was 75% after a mean follow-up of 5±2.8 months. Conclusion Our initial experience suggests that direct implantation of CoreValve TM prosthesis is a safe and feasible therapeutic option for patients with SAS and high surgical risk.
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Méndiz et al. (2012) conducted an observational in Severe aortic stenosis (n=21). Direct implantation of self-expanding CoreValve aortic valve prosthesis was evaluated on Procedural success rate. Direct implantation of the CoreValve prosthesis in patients with severe aortic stenosis and high surgical risk achieved a 95% procedural success rate and 75% cumulative survival at 5 months.
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