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Journal of Cardiothoracic Surgery
Published in: Journal of Cardiothoracic Surgery 1/2015

Open Access 01-12-2015 | Research article

Mid-term results of 150 TAVI comparing apical versus femoral approaches

Authors: Alain Rougé, Olivier Huttin, Rumas Aslam, Thibaud Vaugrenard, Thomas Jouve, Michael Angioi, Pablo Maureira

Published in: Journal of Cardiothoracic Surgery | Issue 1/2015

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Abstract

Background

Transcatheter aortic-valve implantation (TAVI) is a new therapeutic choice for treating aortic stenosis in patients considered high risk for surgery. This blooming therapeutic technique still requires evaluation of medium and long term outcome.

Method

We hereby report our results of the first 150 consecutive patients to receive TAVI implants in our population recruited from July 2009 to March 2013 in a retrospective and monocentric study. We analyzed long term morbidity and mortality criteria. We compared the apical and femoral approach results and researched predictors of cardiac mortality.

Results

The mean monitoring period was 387.62 days, mean Euroscore was 21.8, and mean Society of Thoracic Surgeons (STS) risk score was 9.2. The success rate for the procedure was 94.6 %. A total of 39 patients died. The mortality rates at the immediate perioperative point, 30 days, 1 year, and 2 years, were 4 %, 11.3 %, 22.7 %, and 26 %, respectively. As regards complications, there were 10 hemodynamic complications (6.6 %) and 20 vascular (13.3 %), 11 cardiac tamponades (7.4 %), eight mechanical (5.3 %), ten major hemorrhagic (6.7 %), 14 pulmonary (9.3 %), and 18 infectious complications (12 %). When comparing the rates of reported complications in terms of different approaches, we observed significantly more hemodynamic complications in the apical group (p = 0.049). Pulmonary complications were also significantly more common in cases of apical approach (p = 0.029). The majority of the patients reported clear functional improvement throughout their follow-up.

Conclusion

The results of the first 150 patients to receive the implant at the Nancy University Teaching Hospital (CHU Nancy) were consistent with findings in the literature. TAVI proved a credible and effective alternative to surgical valve replacement for patients at high risk during surgery.
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Metadata
Title
Mid-term results of 150 TAVI comparing apical versus femoral approaches
Authors
Alain Rougé
Olivier Huttin
Rumas Aslam
Thibaud Vaugrenard
Thomas Jouve
Michael Angioi
Pablo Maureira
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Journal of Cardiothoracic Surgery / Issue 1/2015
Electronic ISSN: 1749-8090
DOI
https://doi.org/10.1186/s13019-015-0360-4

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