ABSTRACT
The authors carried out comparative assessment of in-hospital outcomes of transcatheter aortic valve implantation (TAVI) and «open¼ prosthetic repair of the aortic valve. The main criterion for inclusion into the study was the presence of indications for surgical correction of an isolated defect of the aortic valve (AV). Group One comprised 11 patients subjected to TAVI and Group Two (comparison group) consisted of 23 patients undergoing «open¼ prosthetic repair of the AV. There were no statistically significant between-group differences by the main parameters evaluated. In the Comparison Group, there was one lethal outcome; one patient developed significant haemorrhage requiring emergency mediastinotomy; more frequently revealed were pneumonia and hydrothorax, as well as wound complications. Analyzing the obtained results demonstrated comparable in-hospital outcomes of TAVI and «open¼ prosthetic repair of the AV in patients at intermediate surgical risk, despite older age of patients in the TAVI group.
Subject(s)
Aortic Valve Stenosis/surgery , Aortic Valve , Heart Valve Prosthesis Implantation , Postoperative Complications , Transcatheter Aortic Valve Replacement , Aged , Aortic Valve/diagnostic imaging , Aortic Valve/surgery , Aortic Valve Stenosis/diagnosis , Echocardiography/methods , Female , Heart Valve Prosthesis , Heart Valve Prosthesis Implantation/adverse effects , Heart Valve Prosthesis Implantation/methods , Heart Valve Prosthesis Implantation/mortality , Hospital Mortality , Humans , Male , Middle Aged , Outcome and Process Assessment, Health Care , Postoperative Complications/diagnosis , Postoperative Complications/etiology , Postoperative Complications/mortality , Risk Assessment , Risk Factors , Russia , Transcatheter Aortic Valve Replacement/adverse effects , Transcatheter Aortic Valve Replacement/methods , Transcatheter Aortic Valve Replacement/mortalityABSTRACT
STUDY AIM: to assess prognostic value of multifocal atherosclerosis (MFA) relative to risk of new cardiovascular catastrophes in patients with non ST elevation acute coronary syndrome (NSTEACS) during one year follow-up. MATERIAL AND METHODS: atients with NSTEACS (n=266) subjected to coronary angiography and color duplex scanning of peripheral arteries (PA) were included in this study. Presence of "end points" (cardiovascular death, stroke, myocardial infarction, unstable angina, decompensation of heart failure) was assessed after one year of follow-up. RESULTS: aximal GRACE score was revealed in patients with MFA (combined involvement of coronary arteries [CA] and peripheral arteries [PA]). Compared with patients without involvement of CA or PA unfavorable outcomes were 2 times more frequent in the presence of lesions only in CA, 3 times more frequent in the presence of combination of lesions in CA and PA stenoses <50%, 4 times more frequent in the presence of lesions in CA and PA stenosis >50%. Percutaneous coronary intervention at the hospital stage led to 3.3-fold improvement of long term prognosis in patients with single vessel CA involvement and absence of stenoses in PA, and to 1.8 fold improvement - in patients with multivessel CA involvement and PA stenoses >50%. CONCLUSION: resence of even nonsignificant PA stenoses in patients with NSTEACS predetermined high rate of unfavorable events during one year follow-up.
