Abstract
Background: Transcatheter aortic valve implantation (TAVI) has been proposed as a therapeutic option for high-risk or inoperable patients with severe symptomatic aortic valve stenosis. The aim of this multicenter study was to assess early and medium term outcomes of transapical aortic valve implantation (TA-TAVI). Methods: From April 2008 through June 2012, a total of 774 patients were enrolled in the Italian Registry of Trans-Apical Aortic Valve Implantation (I-TA). Twenty-one centers were included in the I-TA registry. Outcomes were also analyzed according to the impact of the learning curve (first 50% cases versus second 50% cases of each center) and of the procedural volume (high-volume versus low-volume centers). Results: Mean age was 81.0 ± 6.7 years, mean logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE) I, EuroSCORE II, and The Society of Thoracic Surgeons risk score were 25.6% ± 16.3%, 9.4% ± 11.0%, and 10.6% ± 8.5%, respectively. Median follow-up was 12 months (range, 1 to 44). Thirty-day mortality was 9.9% (77 patients). Overall 1-, 2-, and 3-year survival was 81.7% ± 1.5%, 76.1% ± 1.9%, and 67.6% ± 3.2%, respectively. Thirty-day mortality of the first 50% patients of each center was higher when compared with the second half (p = 0.04) but 3-year survival was not different (p = 0.64). Conversely, 30-day mortality at low-volume centers versus high-volume centers was similar (p = 0.22). At discharge, peak and mean transprosthetic gradients were 21.0 ± 10.3 mm Hg and 10.2 ± 4.1 mm Hg, respectively. These values remained stable 12 and 24 months after surgery. Conclusions: Transapical TAVI provides good results in terms of early and midterm clinical and hemodynamic outcomes. Thus it appears to be a safe and effective alternative treatment for patients who are inoperable or have high surgical risk.
| Original language | English |
|---|---|
| Pages (from-to) | 830-836 |
| Number of pages | 7 |
| Journal | Annals of Thoracic Surgery |
| Volume | 96 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Sep 2013 |
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ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Surgery
- Pulmonary and Respiratory Medicine
Cite this
Medium term outcomes of transapical aortic valve implantation : Results from the Italian registry of trans-apical aortic valve implantation. / D'Onofrio, Augusto; Salizzoni, Stefano; Agrifoglio, Marco; Cota, Linda; Luzi, Giampaolo; Tartara, Paolo M.; Cresce, Giovanni D.; Aiello, Marco; Savini, Carlo; Cassese, Mauro; Cerillo, Alfredo; Punta, Giuseppe; Cioni, Micaela; Gabbieri, Davide; Zanchettin, Chiara; Agostinelli, Andrea; Mazzaro, Enzo; Di Gregorio, Omar; Gatti, Giuseppe; Faggian, Giuseppe; Filippini, Claudia; Rinaldi, Mauro; Gerosa, Gino.
In: Annals of Thoracic Surgery, Vol. 96, No. 3, 09.2013, p. 830-836.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Medium term outcomes of transapical aortic valve implantation
T2 - Results from the Italian registry of trans-apical aortic valve implantation
AU - D'Onofrio, Augusto
AU - Salizzoni, Stefano
AU - Agrifoglio, Marco
AU - Cota, Linda
AU - Luzi, Giampaolo
AU - Tartara, Paolo M.
AU - Cresce, Giovanni D.
AU - Aiello, Marco
AU - Savini, Carlo
AU - Cassese, Mauro
AU - Cerillo, Alfredo
AU - Punta, Giuseppe
AU - Cioni, Micaela
AU - Gabbieri, Davide
AU - Zanchettin, Chiara
AU - Agostinelli, Andrea
AU - Mazzaro, Enzo
AU - Di Gregorio, Omar
AU - Gatti, Giuseppe
AU - Faggian, Giuseppe
AU - Filippini, Claudia
AU - Rinaldi, Mauro
AU - Gerosa, Gino
PY - 2013/9
Y1 - 2013/9
N2 - Background: Transcatheter aortic valve implantation (TAVI) has been proposed as a therapeutic option for high-risk or inoperable patients with severe symptomatic aortic valve stenosis. The aim of this multicenter study was to assess early and medium term outcomes of transapical aortic valve implantation (TA-TAVI). Methods: From April 2008 through June 2012, a total of 774 patients were enrolled in the Italian Registry of Trans-Apical Aortic Valve Implantation (I-TA). Twenty-one centers were included in the I-TA registry. Outcomes were also analyzed according to the impact of the learning curve (first 50% cases versus second 50% cases of each center) and of the procedural volume (high-volume versus low-volume centers). Results: Mean age was 81.0 ± 6.7 years, mean logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE) I, EuroSCORE II, and The Society of Thoracic Surgeons risk score were 25.6% ± 16.3%, 9.4% ± 11.0%, and 10.6% ± 8.5%, respectively. Median follow-up was 12 months (range, 1 to 44). Thirty-day mortality was 9.9% (77 patients). Overall 1-, 2-, and 3-year survival was 81.7% ± 1.5%, 76.1% ± 1.9%, and 67.6% ± 3.2%, respectively. Thirty-day mortality of the first 50% patients of each center was higher when compared with the second half (p = 0.04) but 3-year survival was not different (p = 0.64). Conversely, 30-day mortality at low-volume centers versus high-volume centers was similar (p = 0.22). At discharge, peak and mean transprosthetic gradients were 21.0 ± 10.3 mm Hg and 10.2 ± 4.1 mm Hg, respectively. These values remained stable 12 and 24 months after surgery. Conclusions: Transapical TAVI provides good results in terms of early and midterm clinical and hemodynamic outcomes. Thus it appears to be a safe and effective alternative treatment for patients who are inoperable or have high surgical risk.
AB - Background: Transcatheter aortic valve implantation (TAVI) has been proposed as a therapeutic option for high-risk or inoperable patients with severe symptomatic aortic valve stenosis. The aim of this multicenter study was to assess early and medium term outcomes of transapical aortic valve implantation (TA-TAVI). Methods: From April 2008 through June 2012, a total of 774 patients were enrolled in the Italian Registry of Trans-Apical Aortic Valve Implantation (I-TA). Twenty-one centers were included in the I-TA registry. Outcomes were also analyzed according to the impact of the learning curve (first 50% cases versus second 50% cases of each center) and of the procedural volume (high-volume versus low-volume centers). Results: Mean age was 81.0 ± 6.7 years, mean logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE) I, EuroSCORE II, and The Society of Thoracic Surgeons risk score were 25.6% ± 16.3%, 9.4% ± 11.0%, and 10.6% ± 8.5%, respectively. Median follow-up was 12 months (range, 1 to 44). Thirty-day mortality was 9.9% (77 patients). Overall 1-, 2-, and 3-year survival was 81.7% ± 1.5%, 76.1% ± 1.9%, and 67.6% ± 3.2%, respectively. Thirty-day mortality of the first 50% patients of each center was higher when compared with the second half (p = 0.04) but 3-year survival was not different (p = 0.64). Conversely, 30-day mortality at low-volume centers versus high-volume centers was similar (p = 0.22). At discharge, peak and mean transprosthetic gradients were 21.0 ± 10.3 mm Hg and 10.2 ± 4.1 mm Hg, respectively. These values remained stable 12 and 24 months after surgery. Conclusions: Transapical TAVI provides good results in terms of early and midterm clinical and hemodynamic outcomes. Thus it appears to be a safe and effective alternative treatment for patients who are inoperable or have high surgical risk.
UR - http://www.scopus.com/inward/record.url?scp=84883223934&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84883223934&partnerID=8YFLogxK
U2 - 10.1016/j.athoracsur.2013.04.094
DO - 10.1016/j.athoracsur.2013.04.094
M3 - Article
C2 - 23870695
AN - SCOPUS:84883223934
VL - 96
SP - 830
EP - 836
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
SN - 0003-4975
IS - 3
ER -