Cor Vasa 2009, 51(11-12):773-780 | DOI: 10.33678/cor.2009.191

Percutaneous CoreValve aortic valve implantation-initial clinical experience in high-risk surgical patients at IKEM

Michael Želízko^1,*, Jiří Malý², Bronislav Janek¹, Ivan Netuka¹, Tomáš Kotulák³, Tomáš Marek¹, Jan Pirk²

¹ Klinika kardiologie

² Klinika kardiovaskulární chirurgie

³ Klinika anesteziologe a resuscitace, Institut klinické a experimentální medicíny, Praha, Česká republika

Background: Percutaneous aortic valve implantation (PAVI) is a recently available technique for interventional treatment of severe aortic stenosis in high-risk surgical patients. We describe our initial clinical experience and short-term (30-day) outcome with percutaneous implantation of the self-expanding CoreValve bioprosthesis.

Methods and results: From December 2008 through June 2009, we performed PAVI procedures (third-generation CoreValve ReValving® system prosthesis) in 21 consecutive patients with symptomatic severe aortic stenosis: 8 males and 13 females, aged 80.9 ± 4.8 years, logistic EuroSCORE 17.5 ± 6.9%, mean aortic pressure gradient 53.6 ± 23 mmHg, aortic valve area 0.43 ± 0.09 cm2/m2, and left ventricular ejection fraction 51.5 ± 9.4%. Procedural success rate was 100%, and the 30-day combined endpoint of MACE was 0% (no death, myocardial infarction or stroke). Pressure gradients improved significantly with a mean final pressure of 3.0 ± 2 mmHg. Overall functional status, as assessed by the New York Heart Association class, improved from 3.0 ± 0.5 to 1.4 ± 0.4 within 30 days post procedure.

Conclusion: PAVI using the CoreValve ReValving® system for selected patients with severe aortic stenosis and high surgical risk is feasible with a high technical success rate, low periprocedural mortality/morbidity and remarkable clinical and hemodynamic improvement. Team approach and experienced hands are essential.

Keywords: Aortic stenosis; Valve prosthesis; Percutaneous approach

Published: November 1, 2009  Show citation