RESUMEN
Background : Transcatheter aortic valve implantation [TAVI] has recently emerged as a therapeutic alternative for high-risk surgical patients with severe symptomatic aortic valve stenosis and has been shown to improve clinical outcomes and reduce all-cause mortality in the PARTNER Trial. However, there is still no published data on similar outcomes in the Lebanon
Objectives : The aim of the study is to evaluate the immediate and short-term results of transfemoral [TF] and transaortic [TAo] TAVI done in Lebanon with 6 months follow-up
Methods: From July 2012 till March 2015, 10 consecutive high-risk and intermediate risk patients with severe symptomatic AS underwent TAVI using Edwards SAPIEN valve. The mean age was 79.4 +/- 6.9 years, logistic EuroSCORE 12.56 +/- 11.78 and mean STS 5.71 +/- 2.44. Patients were equally distributed among genders [50%]. The mean ejection fraction [EF] was 50.0 +/- 14.9% and mean AV area 0.61 +/- 0.1 cm2; mean aortic valve gradient [mAVG] 45.6 +/- 20.2 mmHg, and AV annulus size 21.8 +/- 1.8 mm
Results: TF approach was performed in 9 patients [90%] and TAo in 1 patient [10%]. All valves [17 size 26 mm and 25 size 23 mm] were implanted successfully. The overall 6-month survival was 80%. Grade I paravalvular aortic regurgitation [AR] was present in 60% of the patients; grade II in 10% while none of the patients developed AR with grade III or VI. The post-procedural mean aortic valve gradient [mAVG] was 9.77 +/- 3.31 mmHg; EF was 52.5 +/- 11.9% and immediate postoperative complications included only one case of newonset arrhythmia [AV Block]. After 6 months, one patient died of cardiac arrest following a massive pulmonary embolism while another patient died from a fatal stroke following infective endocarditis affecting the valve prosthesis
Conclusion: TAVI is a feasible technique for intermediate/high risk AS with high success rate and acceptable complications