Interv Akut Kardiol 2010; 9(Suppl.B): 9-13

Transcatheter aortic valve implantation using CoreValve

Michael Želízko¹, Jan Malý², Bronislav Janek¹, Ivan Netuka², Tomáš Kotulák³, Tomáš Marek¹, Jan Pirk²

¹ Klinika kardiologie, IKEM, Praha

² Klinika kardiovaskulární chirurgie, IKEM, Praha

³ Klinika anesteziologie a resuscitace, IKEM, Praha

Percutaneous transcatheter aortic valve implantation (TAVI) is indicated in patients who are significantly limited by symptoms and whose

aortic stenosis is a dominant and haemodynamically significant defect (AVA ≤ 0.5 cm2/m2). They include advanced-age patients (over 75

years), those with a high surgical risk who are not candidates for classic surgical aortic valve replacement, and specific situations when

surgery is not technically feasible (porcelain aorta, following CABG, following radiation therapy in the chest area, etc.). The indications and

contraindications for the procedure with respect to the specific features of CoreValve, description of the procedure, and our experience to

date are presented. Between December 2008 and February 2010, CoreValve aortic valve implantation was performed in 30 patients with

severe aortic stenosis. A total of 11 men and 19 women with a mean age of 81.4 ± 6.1 years (69–92) had a mean EuroSCORE of 19.3 ± 8.9 %

(8–42), a mean aortic pressure gradient of 59.8 ± 19.8 mm Hg (30–86 mm Hg), an aortic valve area of 0.37 ± 0.11 cm2/m2 (0.16–0.58 cm2/

m2), and a mean ejection fraction of 53 % ± 10 % (25–70 %). The procedural success rate was 100 % and no serious complication occurred

during the initial 30 days (MACE – death, myocardial infarction or stroke – 0 %). There was a significant decrease in the mean aortic pressure

gradient with a mean final pressure of 3.0 ± 2 mm Hg (0–5 mm Hg). The overall functional status, as assessed by the New York Heart

Association classification, improved markedly from 3.1 ± 0.4 prior to procedure to 1.4 ± 0.4 within 30 days post procedure. In patients

with significant aortic stenosis and a high surgical risk, percutaneous aortic valve implantation using the CoreValve ReValving® system

is a procedure with a high success rate, reasonable periprocedural risk, and clear clinical as well as haemodynamic improvement. Team

approach and experienced hands are essential.

Keywords: aortic stenosis, valve prosthesis, transcatheter implantation

Published: April 1, 2010  Show citation