Brazilian Journal of Cardiovascular Surgery ()

Transcatheter Aortic Valve Replacement: The Experience of One Brazilian Health Care Center

  • Fabiula Schwartz Azevedo,
  • Marcelo Goulart Correa,
  • Débora Holanda Gonçalves Paula,
  • Alex dos Santos Felix,
  • Luciano Herman Juaçaba Belém,
  • Ana Paula Chedid Mendes,
  • Valeria Gonçalves Silva,
  • Bruno Miranda Marques,
  • Andrey José de Oliveira Monteiro,
  • Clara Weksler,
  • Alexandre Siciliano Colafranceschi,
  • Daniel Arthur Barata Kasal

DOI
https://doi.org/10.21470/1678-9741-2017-0117
Journal volume & issue
Vol. 33, no. 1
pp. 1 – 7

Abstract

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Abstract Objective: Transcatheter aortic valve replacement has been an alternative to invasive treatment for symptomatic severe aortic stenosis in high risk patients. The primary endpoint was 30-day and 1-year mortality from any cause. Secondary endpoints were to compare the clinical and echocardiographic variation pre-and post- transcatheter aortic valve replacement, and the occurrence of complications throughout a 4-year follow-up period. Methods: This prospective cohort, nestled to a multicenter study (Registro Brasileiro de Implante de Bioprótese por Cateter), describes the experience of a public tertiary center in transcatheter aortic valve replacement. All patients who underwent this procedure between October 2011 and February 2016 were included. Results: Fifty-eight patients underwent transcatheter aortic valve replacement. The 30-day all-cause mortality was 5.2% (n=3) and after 1 year was 17.2% (n=10). A significant improvement in New York Heart Association functional classification was observed when comparing pre-and post- transcatheter aortic valve replacement (III or IV 84.4% versus 5.8%; P<0.001). A decline in peak was observed (P<0.001) and mean (P<0.001) systolic transaortic gradient. The results of peak and mean post-implant transaortic gradient were sustained after one year (P=0.29 and P=0.36, respectively). Left ventricular ejection fraction did not change significantly during follow-up (P=0.41). The most frequent complications were bleeding (28.9%), the need for permanent pacemaker (27.6%) and acute renal injury (20.6%). Conclusion: Mortality and complications in this study were consistent with worldwide experience. Transcatheter aortic valve replacement had positive clinical and hemodynamic results, when comparing pre-and post-procedure, and the hemodynamic profile of the prosthesis was sustained throughout follow-up.

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