The Acute and 3-Month Outcomes of Transcatheter Aortic Valve Implantation in Taiwan

Background: Transcatheter aortic valve implantation (TAVI) has emerged as an alternative to surgical aortic valve replacement for symptomatic severe aortic stenosis (AS) patients with high surgical risk. This study demonstrates the acute and 3-month outcomes of the first case series of TAVI in Taiwan.Methods: This study enrolled severe symptomatic AS patients who were evaluated by surgeons as having high surgical risk. The procedural and 3-month outcomes were evaluated. The Edwards SAPIEN valves were delivered via the transfemoral (TF) or transapical (TA) approaches. Results: Between May and October 2010, 10 patients received TAVI (4 via TF and 6 via TA approach). The procedures were successful in all cases. No major complications occurred within the first 24 hours after the procedure. At 3-month follow-up, no cardiovascular death occurred. One patient died of pneumonia after the TA procedure. Another TA patient developed myocardial tear 3 days after the procedure. After TAVI, none of the patients had more than grade 2 AR at discharge and 3-month follow-up. The aortic-valve area increased from 0.61 ± 0.19 cm2 to 1.42 ± 0.20 cm2 (p ＜ 0.001), and the mean aortic valve gradient decreased from 48 ± 16 mm Hg to 11 ± 2mm Hg (p ＜ 0.001).Conclusion: The immediate and short-term outcomes were encouraging in our first 10 TAVI cases. Nevertheless,multi-specialty collaboration, pre-procedural evaluation with multimodality imaging, and proper patient selection are the cornerstones of success in treating these high-risk patients.