Results of percutaneous and transapical transcatheter aortic valve implantation performed by a surgical team
Objective: Transcatheter aortic valve implantation has been performed by several groups, most of them either specializing on the transapical (surgeons) or the percutaneous femoral transarterial approach (cardiologists). We achieved both transapical and percutaneous transcatheter valve implantation b...
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| Veröffentlicht in: | European journal of cardio-thoracic surgery 2009-04, Vol.35 (4), p.615-621 |
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| container_title | European journal of cardio-thoracic surgery |
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| creator | Bleiziffer, Sabine Ruge, Hendrik Mazzitelli, Domenico Schreiber, Christian Hutter, Andrea Laborde, Jean-Claude Bauernschmitt, Robert Lange, Ruediger |
| description | Objective: Transcatheter aortic valve implantation has been performed by several groups, most of them either specializing on the transapical (surgeons) or the percutaneous femoral transarterial approach (cardiologists). We achieved both transapical and percutaneous transcatheter valve implantation by a surgical team in a hybrid suite. Methods: Since June 2007, 137 patients (n = 78 female, mean age 81 ± 7 years) underwent transcatheter aortic valve implantation (n = 109 transfemoral, n = 3 via subclavian artery, n = 2 directly through ascending aorta, n = 23 transapical) with the CoreValve (n = 114) or the Edwards Sapien (n = 23) prosthesis. Results: Thirty-day mortality was 12.4% in this patient cohort. One hundred and eight patients (78.8%) are alive at a mean follow-up of 97 ± 82 days. Pacemaker implantation due to postoperative AV block was performed in 27 patients (19.7%), and 7 patients (5.1%) sustained neurological events. Patients improved in NYHA class (from 3.1 ± 0.3 to 1.9 ± 0.5, p |
| doi_str_mv | 10.1016/j.ejcts.2008.12.041 |
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We achieved both transapical and percutaneous transcatheter valve implantation by a surgical team in a hybrid suite. Methods: Since June 2007, 137 patients (n = 78 female, mean age 81 ± 7 years) underwent transcatheter aortic valve implantation (n = 109 transfemoral, n = 3 via subclavian artery, n = 2 directly through ascending aorta, n = 23 transapical) with the CoreValve (n = 114) or the Edwards Sapien (n = 23) prosthesis. Results: Thirty-day mortality was 12.4% in this patient cohort. One hundred and eight patients (78.8%) are alive at a mean follow-up of 97 ± 82 days. Pacemaker implantation due to postoperative AV block was performed in 27 patients (19.7%), and 7 patients (5.1%) sustained neurological events. Patients improved in NYHA class (from 3.1 ± 0.3 to 1.9 ± 0.5, p < 0.001) and in self-assessed health state (from 55 ± 17% to 68 ± 16%, p < 0.001) at one-month follow-up. Echocardiographic assessment revealed excellent hemodynamic function of the prostheses with a mean aortic gradient (MAG) of 11.9 ± 4.4 mmHg and an effective orifice area (EOA) of 1.6 ± 0.4 cm2 at discharge and a MAG of 11.0 ± 4.2 mmHg and an EOA of 1.6 ± 0.3 cm2 at six months FU. Conclusions: Transcatheter aortic valve implantation has become an alternative technique for the treatment of aortic stenosis with reasonable short- and mid-term results at our institution. With the opportunity to treat aortic stenosis by conventional surgical valve replacement and transapical and percutaneous transcatheter procedures, the technique of lowest risk for the individual patient can be chosen and performed by one team.</description><identifier>ISSN: 1010-7940</identifier><identifier>EISSN: 1873-734X</identifier><identifier>DOI: 10.1016/j.ejcts.2008.12.041</identifier><identifier>PMID: 19233669</identifier><language>eng</language><publisher>Germany: Elsevier Science B.V</publisher><subject>Aged ; Aged, 80 and over ; Aortic stenosis ; Aortic Valve - surgery ; Aortic Valve Stenosis - physiopathology ; Aortic Valve Stenosis - surgery ; Cardiac Catheterization - methods ; Epidemiologic Methods ; Female ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation - methods ; Hemodynamics ; Humans ; Interventional ; Male ; Minimally invasive ; Minimally Invasive Surgical Procedures - methods ; Treatment Outcome ; Valves</subject><ispartof>European journal of cardio-thoracic surgery, 2009-04, Vol.35 (4), p.615-621</ispartof><rights>European Association for Cardio-Thoracic Surgery © 2008 European Association for Cardio-Thoracic Surgery 2008</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c461t-6295f887916cc0ff8a6da1fa2ea1e0fbf21c516a6e6405dc986179e8f417930d3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19233669$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bleiziffer, Sabine</creatorcontrib><creatorcontrib>Ruge, Hendrik</creatorcontrib><creatorcontrib>Mazzitelli, Domenico</creatorcontrib><creatorcontrib>Schreiber, Christian</creatorcontrib><creatorcontrib>Hutter, Andrea</creatorcontrib><creatorcontrib>Laborde, Jean-Claude</creatorcontrib><creatorcontrib>Bauernschmitt, Robert</creatorcontrib><creatorcontrib>Lange, Ruediger</creatorcontrib><title>Results of percutaneous and transapical transcatheter aortic valve implantation performed by a surgical team</title><title>European journal of cardio-thoracic surgery</title><addtitle>Eur J Cardiothorac Surg</addtitle><addtitle>Eur J Cardiothorac Surg</addtitle><description>Objective: Transcatheter aortic valve implantation has been performed by several groups, most of them either specializing on the transapical (surgeons) or the percutaneous femoral transarterial approach (cardiologists). We achieved both transapical and percutaneous transcatheter valve implantation by a surgical team in a hybrid suite. Methods: Since June 2007, 137 patients (n = 78 female, mean age 81 ± 7 years) underwent transcatheter aortic valve implantation (n = 109 transfemoral, n = 3 via subclavian artery, n = 2 directly through ascending aorta, n = 23 transapical) with the CoreValve (n = 114) or the Edwards Sapien (n = 23) prosthesis. Results: Thirty-day mortality was 12.4% in this patient cohort. One hundred and eight patients (78.8%) are alive at a mean follow-up of 97 ± 82 days. Pacemaker implantation due to postoperative AV block was performed in 27 patients (19.7%), and 7 patients (5.1%) sustained neurological events. Patients improved in NYHA class (from 3.1 ± 0.3 to 1.9 ± 0.5, p < 0.001) and in self-assessed health state (from 55 ± 17% to 68 ± 16%, p < 0.001) at one-month follow-up. Echocardiographic assessment revealed excellent hemodynamic function of the prostheses with a mean aortic gradient (MAG) of 11.9 ± 4.4 mmHg and an effective orifice area (EOA) of 1.6 ± 0.4 cm2 at discharge and a MAG of 11.0 ± 4.2 mmHg and an EOA of 1.6 ± 0.3 cm2 at six months FU. Conclusions: Transcatheter aortic valve implantation has become an alternative technique for the treatment of aortic stenosis with reasonable short- and mid-term results at our institution. With the opportunity to treat aortic stenosis by conventional surgical valve replacement and transapical and percutaneous transcatheter procedures, the technique of lowest risk for the individual patient can be chosen and performed by one team.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aortic stenosis</subject><subject>Aortic Valve - surgery</subject><subject>Aortic Valve Stenosis - physiopathology</subject><subject>Aortic Valve Stenosis - surgery</subject><subject>Cardiac Catheterization - methods</subject><subject>Epidemiologic Methods</subject><subject>Female</subject><subject>Heart Valve Prosthesis</subject><subject>Heart Valve Prosthesis Implantation - methods</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Interventional</subject><subject>Male</subject><subject>Minimally invasive</subject><subject>Minimally Invasive Surgical Procedures - methods</subject><subject>Treatment Outcome</subject><subject>Valves</subject><issn>1010-7940</issn><issn>1873-734X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkE1rFTEUhoNYbK3-AkGyczXjSTI3mSyl2F6hIJQKFzfh3MyJznW-TDKl_fed61x06-q8i_d54TyMvRNQChD646Gkg8-plAB1KWQJlXjBLkRtVGFUtXu5ZBBQGFvBOXud0gEAtJLmFTsXViqltb1g3R2lucuJj4FPFP2ccaBxThyHhueIQ8Kp9dit2WP-SZkixzHm1vMH7B6It_3U4ZAxt-NwHAlj7Knh-yeOPM3xx8oT9m_YWcAu0dvTvWTfrj_fX22L2683X64-3Ra-0iIXWtpNqGtjhfYeQqhRNygCSkJBEPZBCr8RGjXpCjaNt7UWxlIdquUoaNQl-7DuTnH8PVPKrm-Tp65bf3NGKSWF1bA01dr0cUwpUnBTbHuMT06AO1p2B_fHsjtadkK6xfJCvT_tz_vl03_MSetSKNfCOE__uVisQJsyPf5FMP5y2iizcdvddwc31fZe253T6hmc0pp_</recordid><startdate>200904</startdate><enddate>200904</enddate><creator>Bleiziffer, Sabine</creator><creator>Ruge, Hendrik</creator><creator>Mazzitelli, Domenico</creator><creator>Schreiber, Christian</creator><creator>Hutter, Andrea</creator><creator>Laborde, Jean-Claude</creator><creator>Bauernschmitt, Robert</creator><creator>Lange, Ruediger</creator><general>Elsevier Science B.V</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200904</creationdate><title>Results of percutaneous and transapical transcatheter aortic valve implantation performed by a surgical team</title><author>Bleiziffer, Sabine ; Ruge, Hendrik ; Mazzitelli, Domenico ; Schreiber, Christian ; Hutter, Andrea ; Laborde, Jean-Claude ; Bauernschmitt, Robert ; Lange, Ruediger</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c461t-6295f887916cc0ff8a6da1fa2ea1e0fbf21c516a6e6405dc986179e8f417930d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aortic stenosis</topic><topic>Aortic Valve - surgery</topic><topic>Aortic Valve Stenosis - physiopathology</topic><topic>Aortic Valve Stenosis - surgery</topic><topic>Cardiac Catheterization - methods</topic><topic>Epidemiologic Methods</topic><topic>Female</topic><topic>Heart Valve Prosthesis</topic><topic>Heart Valve Prosthesis Implantation - methods</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Interventional</topic><topic>Male</topic><topic>Minimally invasive</topic><topic>Minimally Invasive Surgical Procedures - methods</topic><topic>Treatment Outcome</topic><topic>Valves</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bleiziffer, Sabine</creatorcontrib><creatorcontrib>Ruge, Hendrik</creatorcontrib><creatorcontrib>Mazzitelli, Domenico</creatorcontrib><creatorcontrib>Schreiber, Christian</creatorcontrib><creatorcontrib>Hutter, Andrea</creatorcontrib><creatorcontrib>Laborde, Jean-Claude</creatorcontrib><creatorcontrib>Bauernschmitt, Robert</creatorcontrib><creatorcontrib>Lange, Ruediger</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of cardio-thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bleiziffer, Sabine</au><au>Ruge, Hendrik</au><au>Mazzitelli, Domenico</au><au>Schreiber, Christian</au><au>Hutter, Andrea</au><au>Laborde, Jean-Claude</au><au>Bauernschmitt, Robert</au><au>Lange, Ruediger</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Results of percutaneous and transapical transcatheter aortic valve implantation performed by a surgical team</atitle><jtitle>European journal of cardio-thoracic surgery</jtitle><stitle>Eur J Cardiothorac Surg</stitle><addtitle>Eur J Cardiothorac Surg</addtitle><date>2009-04</date><risdate>2009</risdate><volume>35</volume><issue>4</issue><spage>615</spage><epage>621</epage><pages>615-621</pages><issn>1010-7940</issn><eissn>1873-734X</eissn><abstract>Objective: Transcatheter aortic valve implantation has been performed by several groups, most of them either specializing on the transapical (surgeons) or the percutaneous femoral transarterial approach (cardiologists). We achieved both transapical and percutaneous transcatheter valve implantation by a surgical team in a hybrid suite. Methods: Since June 2007, 137 patients (n = 78 female, mean age 81 ± 7 years) underwent transcatheter aortic valve implantation (n = 109 transfemoral, n = 3 via subclavian artery, n = 2 directly through ascending aorta, n = 23 transapical) with the CoreValve (n = 114) or the Edwards Sapien (n = 23) prosthesis. Results: Thirty-day mortality was 12.4% in this patient cohort. One hundred and eight patients (78.8%) are alive at a mean follow-up of 97 ± 82 days. Pacemaker implantation due to postoperative AV block was performed in 27 patients (19.7%), and 7 patients (5.1%) sustained neurological events. Patients improved in NYHA class (from 3.1 ± 0.3 to 1.9 ± 0.5, p < 0.001) and in self-assessed health state (from 55 ± 17% to 68 ± 16%, p < 0.001) at one-month follow-up. Echocardiographic assessment revealed excellent hemodynamic function of the prostheses with a mean aortic gradient (MAG) of 11.9 ± 4.4 mmHg and an effective orifice area (EOA) of 1.6 ± 0.4 cm2 at discharge and a MAG of 11.0 ± 4.2 mmHg and an EOA of 1.6 ± 0.3 cm2 at six months FU. Conclusions: Transcatheter aortic valve implantation has become an alternative technique for the treatment of aortic stenosis with reasonable short- and mid-term results at our institution. With the opportunity to treat aortic stenosis by conventional surgical valve replacement and transapical and percutaneous transcatheter procedures, the technique of lowest risk for the individual patient can be chosen and performed by one team.</abstract><cop>Germany</cop><pub>Elsevier Science B.V</pub><pmid>19233669</pmid><doi>10.1016/j.ejcts.2008.12.041</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Aged, 80 and over Aortic stenosis Aortic Valve - surgery Aortic Valve Stenosis - physiopathology Aortic Valve Stenosis - surgery Cardiac Catheterization - methods Epidemiologic Methods Female Heart Valve Prosthesis Heart Valve Prosthesis Implantation - methods Hemodynamics Humans Interventional Male Minimally invasive Minimally Invasive Surgical Procedures - methods Treatment Outcome Valves |
| title | Results of percutaneous and transapical transcatheter aortic valve implantation performed by a surgical team |
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