PMID- 23977483
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20130826
LR  - 20211021
IS  - 2225-319X (Print)
IS  - 2304-1021 (Electronic)
IS  - 2225-319X (Linking)
VI  - 1
IP  - 2
DP  - 2012 Jul
TI  - Transapical aortic valve implantation - The Leipzig experience.
PG  - 129-37
LID - 10.3978/j.issn.2225-319X.2012.06.09 [doi]
AB  - BACKGROUND: Transcatheter aortic valve implantation (TAVI) represents a 
      significant development in the treatment of high risk patients with aortic 
      stenosis. As one of the first centers to perform transapical TAVI (taTAVI), we 
      herein review our five-year experience with this technique. METHODS: All patients 
      undergoing taTAVI with an Edwards Sapien valve at the Leipzig Heart Center 
      between 2006 and 2011 (n=439) were analysed. Data was drawn from a prospective 
      database and retrospectively analysed. The learning curve was reviewed by means 
      of descriptive statistics as well as cumulative sum failure analysis (CUSUM). All 
      results are presented in compliance with Valve Academic Research Consortium 
      (VARC) criteria. RESULTS: The mean patient age was 81.5+/-6.4 years and 64.0% were 
      female. The mean logistic EuroSCORE and STS risk of mortality were 29.7%+/-15.7% 
      and 11.4%+/-7.6%, respectively. Procedural success was 90.2%. Stroke occurred in 
      2.1% of patients intra-operatively and a further 2.1% suffered stroke during 
      their hospital stay. Mean transvalvular gradient was 9.0+/-3.9 mmHg and effective 
      valve orifice area 1.3+/-0.6 cm(2). Moderate or greater aortic insufficiency was 
      present in 5.7% of patients and remained stable during follow up. Overall 
      survival was 90% at 30 days, 73% at 1 year, 68% at 2 years, 58% at 3 years, 53% 
      at 4 years, and 44% at 5 years. CUSUM analysis revealed a definitive learning 
      curve regarding the occurrence of major complications, with a progressive 
      improvement after the initial 150 cases. CONCLUSION: TaTAVI has become a routine 
      approach for high risk patients with symptomatic severe aortic stenosis. Although 
      taTAVI is a safe procedure with reproducible results, future research should 
      focus on methods of reducing known complications and the associated learning 
      curve for this procedure.
FAU - Holzhey, David M
AU  - Holzhey DM
AD  - Department of Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany.
FAU - Hansig, Martin
AU  - Hansig M
FAU - Walther, Thomas
AU  - Walther T
FAU - Seeburger, Joerg
AU  - Seeburger J
FAU - Misfeld, Martin
AU  - Misfeld M
FAU - Linke, Axel
AU  - Linke A
FAU - Borger, Michael A
AU  - Borger MA
FAU - Mohr, Friedrich W
AU  - Mohr FW
LA  - eng
PT  - Journal Article
PL  - China
TA  - Ann Cardiothorac Surg
JT  - Annals of cardiothoracic surgery
JID - 101605877
PMC - PMC3741744
OTO - NOTNLM
OT  - Transcatheter aortic valve implantation (TAVI)
OT  - aortic stenosis
OT  - transapical TAVI (taTAVI)
EDAT- 2013/08/27 06:00
MHDA- 2013/08/27 06:01
PMCR- 2012/07/01
CRDT- 2013/08/27 06:00
PHST- 2012/05/18 00:00 [received]
PHST- 2012/06/19 00:00 [accepted]
PHST- 2013/08/27 06:00 [entrez]
PHST- 2013/08/27 06:00 [pubmed]
PHST- 2013/08/27 06:01 [medline]
PHST- 2012/07/01 00:00 [pmc-release]
AID - acs-01-02-129 [pii]
AID - 10.3978/j.issn.2225-319X.2012.06.09 [doi]
PST - ppublish
SO  - Ann Cardiothorac Surg. 2012 Jul;1(2):129-37. doi: 
      10.3978/j.issn.2225-319X.2012.06.09.