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32. Cardiovascular Nursing
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Long term durability of self-expanding transcatheter aortic valve prostheses
Session:
Painel 10-Doença Valvular 2
Speaker:
Tiago Mendonça
Congress:
CPC 2020
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
15. Valvular Heart Disease
Subtheme:
15.4 Valvular Heart Disease – Treatment
Session Type:
Posters
FP Number:
---
Authors:
Tiago Mendonça; Lino Patrício ; Dra. Inês Rodrigues; Tânia Branco Mano; Duarte Cacela; Ruben Ramos; Hagen Kahlbau; Isabel Fragata; José Fragata
Abstract
<p><strong>Introduction</strong>: Transcatheter aortic valve implantation (TAVI) is an established treatment for patients with severe aortic stenosis. However, there is a paucity of long-term data on the durability of percutaneous valves.</p> <p><strong>Aim:</strong> Evaluate the long-term valve durability and structural degeneration of self-expanding transcatheter valves.</p> <p><strong>Methods:</strong> We retrospectively examined inoperable or high-risk patients who underwent TAVI with a self-expanding valve from 2009 to 2014 at our institution. A descriptive statistical study was performed, and survival study was performed by Kaplan-Meier analysis.</p> <p><strong>Results: </strong>70 patients (50% male, mean age 80.3 ± 6.3 years) who were successfully submitted to TAVI with a self-expanding Corevalve prosthesis and were discharged alive were analysed. All patients underwent TAVI for pure aortic stenosis. Mean STS score and mean Euroscore II were 5.8% and 6.2%, respectively. Baseline mean transvalvular gradient was 57 mmHg.</p> <p>Mean clinical follow-up was 52.2 ± 30.3 months. In the most recent echocardiographic evaluation (mean time after TAVI 34.7 months) there were no significant differences in peak aortic valve gradient (17.8 mmHg vs 15.9 mmHg, p = 0.08) or mean gradient (9.9 mmHg vs 8.8 mmHg, p = 0.3) at follow-up. Rates of mild and moderate paravalvular leak were 41.4% and 4.3% at baseline and at follow-up 35.7% and 1.4%, respectively. No patient developed new severe aortic regurgitation. There was one case of prosthetic dysfunction (mean gradient > 20 mmHg) and one case of infective endocarditis. There were no cases of prosthetic valve dysfunction requiring valve replacement. A total of 36 patients (51.4%) died during follow-up, 47.2% due to cardiovascular causes. The median survival estimated by Kaplan-Meier was 67.1 ± 5.3 months.</p> <p><strong>Conclusions:</strong> Long term valve function was excellent, with no increase in valve gradients or regurgitation over time. Long term survival was acceptable, considering the elderly and high risk population and was consistent with other long-term studies.</p>
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