Universität zu Köln

Useini, Dritan, Haldenwang, Peter, Schloemicher, Markus, Christ, Hildegard ORCID: 0000-0003-3235-2994, Naraghi, Hamid, Moustafine, Vadim and Strauch, Justus (2020). Mid-Term Outcomes after Transapical and Transfemoral Transcatheter Aortic Valve Implantation for Aortic Stenosis and Porcelain Aorta with a Systematic Review of Transfemoral versus Transapical Approach. Thorac. Cardiovasc. Surg., 68 (7). S. 623 - 633. STUTTGART: GEORG THIEME VERLAG KG. ISSN 1439-1902

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Abstract

Background We have aimed to analyze early and mid-term outcomes of patients undergoing transapical/transfemoral transcatheter aortic valve implantation (TA-/TF-TAVI) for aortic stenosis and porcelain aorta (PAo) in our institution. Additionally, we postulated that the TA approach may be associated with a more favorable neurological outcome than the TF approach; hence, a systematic literature review was conducted. Methods Between 2011 and 2017, 15 patients with PAo underwent TA-TAVI and 4 patients with PAo TF-TAVI at our institution. The assessment of PAo was done either intraoperatively after aborted sternotomy or via computed tomography for elective TAVI. We conducted mid-term follow-up. Furthermore, a systematic review was performed to compare the mortality and neurological outcomes of TF and TA-TAVI approaches. Results TA/TF-TAVIs were performed with 100% device success, without paravalvular leakage >= 2 and without procedural death. The 30-day mortality/stroke rates were 6.6%/0% in TA-TAVI and 0%/25% in TF-TAVI, respectively. The 6-month, 1-year, and 2-year survival rates were in TA/TF-TAVI 93%/75%, 82%/66.6%, and 50%/0%, respectively. The pooled results derived from the literature review were as follows: The prevalence of PAo in the TAVI population is 9.74%; the mean logistic EuroSCORE is 41.9% in TA-TAVI versus 16.2% in TF-TAVI; the mean 30-day mortality is 5.9% in TA-TAVI versus 6.3% in TF-TAVI, and the mean stroke is 0.8% in TA-TAVI versus 9% in TF-TAVI. Conclusion TA-TAVI shows promising early and mid-term outcomes in patients with PAo. TF-TAVI performed in patients with PAo is likely to be associated with higher rates of stroke than TA-TAVI.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Useini, Dritan UNSPECIFIED UNSPECIFIED UNSPECIFIED Haldenwang, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Schloemicher, Markus UNSPECIFIED UNSPECIFIED UNSPECIFIED Christ, Hildegard UNSPECIFIED orcid.org/0000-0003-3235-2994 UNSPECIFIED Naraghi, Hamid UNSPECIFIED UNSPECIFIED UNSPECIFIED Moustafine, Vadim UNSPECIFIED UNSPECIFIED UNSPECIFIED Strauch, Justus UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-316871
DOI:	10.1055/s-0039-1692719
Journal or Publication Title:	Thorac. Cardiovasc. Surg.
Volume:	68
Number:	7
Page Range:	S. 623 - 633
Date:	2020
Publisher:	GEORG THIEME VERLAG KG
Place of Publication:	STUTTGART
ISSN:	1439-1902
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CEREBROVASCULAR EVENTS; ABORTED STERNOTOMY; REPLACEMENT; REGISTRY; PREDICTORS Multiple languages Cardiac & Cardiovascular Systems; Respiratory System; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/31687