Universität zu Köln

Useini, Dritan ORCID: 0000-0002-8312-330X, Beluli, Blerta ORCID: 0000-0003-2155-0354, Christ, Hildegard and Strauch, Justus (2021). Impact of diverse aortic pathologies on outcomes after transapical transcatheter aortic valve replacement. J. Card. Surg., 36 (7). S. 2240 - 2247. HOBOKEN: WILEY. ISSN 1540-8191

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Abstract

Objectives Some patients who undergo transcatheter aortic valve replacement (TAVR) have a concomitant diverse aortic pathologies (AP). They are usually considered high-risk candidates for the procedure and require further assessment to determine the best vascular approach. The impact of these AP on TAVR is not well known as the information is scarce. We aimed to evaluate midterm clinical impact of different AP after transapical (TA)-TAVR. Methods Twenty patients with atherosclerotic/occluding aortic diseases (A/OAD) (porcelain aorta, Leriche Syndrome, penetrating aortic ulcer, and aortic thrombus), 24 patients with aortic morphologic diseases (AMD) (thoracic/abdominal aortic aneurysms, aortic kinking, aortic type B dissection, aortic elongation/tortuosity, and previous aortic intervention), and 11 patients with combined aortic diseases (CAD) underwent TA-TAVR treatment between January 2011 and November 2019 at our center. We conducted up to 5-years clinical follow-up. Results All patients were classified in the heart team as a high interventional risk. The 30-day mortality and stroke were 5% and 10% in the A/OAD, 8.3% and 0% in the AMD, and 0% and 0% in the CAD, respectively. The median time of freedom from a composite of death and cardio-cerebral adverse events was 22.1 months [95% confidence interval [CI]: 9.9-34.3] in A/OAD versus 34.3 months [95% CI: 15.6-53] in AMD versus 17 months [95% CI: 0-39.4] in CAD; p = .525. We registered neither procedural aortic injury nor aortic syndrome at follow-up. The moderate/severe paravalvular leakage rates were 5%, 0% and 0% in the A/OAD, AMD and CAD, respectively. Conclusion Independent of underlying AP, the TA-TAVR is a safe method and shows very promising early and midterm outcomes in patients with various AP.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Useini, Dritan UNSPECIFIED orcid.org/0000-0002-8312-330X UNSPECIFIED Beluli, Blerta UNSPECIFIED orcid.org/0000-0003-2155-0354 UNSPECIFIED Christ, Hildegard UNSPECIFIED UNSPECIFIED UNSPECIFIED Strauch, Justus UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-580958
DOI:	10.1111/jocs.15516
Journal or Publication Title:	J. Card. Surg.
Volume:	36
Number:	7
Page Range:	S. 2240 - 2247
Date:	2021
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1540-8191
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language Cardiac & Cardiovascular Systems; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/58095