Transcatheter aortic valve implantation: the first applications and early results in Turkey [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2010; 38(4): 258-263

Transcatheter aortic valve implantation: the first applications and early results in Turkey

Genco Yücel1, Tufan Paker2, Atıf Akçevin2, Alpay Sezer1, Alpaslan Eryılmaz1, Tolga Özyiğit1, Ali Sezer3, Sergin Akpek4, Halil Türkoğlu2, Alain Cribier5
1VKV American Hospital, Cardiology Department, Istanbul, Turkey
2VKV American Hospital, Cardiac Surgery Department, Istanbul, Turkey
3VKV American Hospital, Anesthesiology Department, Istanbul, Turkey
4VKV American Hospital, Radiology Department, Istanbul, Turkey
5Charles Nicole University Hospital, Cardiology Department, Rouen, France


OBJECTIVES
The objective of this study was to evaluate the first applications and results of transcatheter aortic valve implantation (TAVI) in Turkey, which is a new technology for the treatment of aortic valve stenosis.

STUDY DESIGN
We performed TAVI in eight severely symptomatic patients (5 women, 3 men; mean age 81.6±6.7 years; range 71 to 95 years) between May 1 and December 31, 2009. All the patients had severe aortic stenosis (mean valve area 0.6 cm2, systolic peak/mean gradients 80.5±22.1/50.0±16.1 mmHg). Two patients had severe coronary artery disease that required intervention during TAVI. All the patients presented a high surgical risk (EuroSCORE 31.1±9.8 and STS score 12.8±7.9). The Edwards Sapien bioprosthetic valve was implanted through the transfemoral approach in seven patients, and transapical approach in one patient.

RESULTS
All prosthetic valves were of appropriate size, were implanted in appropriate locations, and functioned perfectly. Two patients with severe coronary stenosis underwent successful simultaneous percutaneous coronary intervention before TAVI. Following TAVI, the mean aortic valve area increased to 1.5±0.1 cm2 (p<0.01), and systolic/mean gradients decreased to 27.6±9.6/14.6±5.8 mmHg (p<0.01). One patient underwent permanent pacemaker implantation due to persistent atrioventricular block, and two patients had transient atrioventricular block. Two patients died; one on the first day following transapical implantation, and the other after six months of implantation. The mean NYHA functional class decreased from preoperative 3.8±0.3, to 1.1±0.3 after a mean follow-up of 3.5±2.5 months (range 1 to 8 months) (p<0.01).

CONCLUSION
Early results of TAVI are successful in patients with inoperable aortic valve stenosis due to high surgical risk. The results of randomized studies with longer follow-up will clarify widespread use of this technique.

Keywords: Aortic valve/surgery, aortic valve stenosis/surgery, heart catheterization/methods, heart valve prosthesis

How to cite this article
Genco Yücel, Tufan Paker, Atıf Akçevin, Alpay Sezer, Alpaslan Eryılmaz, Tolga Özyiğit, Ali Sezer, Sergin Akpek, Halil Türkoğlu, Alain Cribier. Transcatheter aortic valve implantation: the first applications and early results in Turkey. Turk Kardiyol Dern Ars. 2010; 38(4): 258-263

Corresponding Author: Tufan Paker, Türkiye
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