Hasan Bushnaq, MD Department of Cardiothoracic Surgery, Martin-Luther University, Halle / Germany
TAVI Percentage in Germany
There is no Rose without Thorns
The Thorns of TAVI Stroke and Vascular Complication
Martin B. Leon et al, N Engl J Med 2012;366:1686-95
CoreVlave Advance Study
The Thorns of TAVI Impact of PVL
Martin B. Leon et al, N Engl J Med 2012;366:1686-95
Access Routes
Simplicity
Purse-String-Suture
Flexibility
Flexibility
Safety
Patient Demographics, Halle 75 patients underwent TAVI with the Medtronic CoreValve via Direct Aortic Access between October 2011 and December 2012
Age
79 Âą 4.3 (58-93)
Gender (Male)
37/75 (49%)
NYHA class III and IV
66/75 (88%)
Coronary Artery Disease
47/75 (63%)
Prior CABG
13/75 (17%)
Peripheral Vascular Disease
27/75 (36%)
Logistic Euroscore
25 Âą 14,2 (3,5-94)
Results, Halle 30 day Mortality
7/75 (9%)
In-hospital Stroke
1/75 (1,3%)
Psycho-organic syndrome
17/75 (23%)
No – Trace aortic regurgitation
68/75 (91%)
Major Vascular Injury (VARC)
0/75 (0%)
Conversion to Full Sternotomy
1/75 (1,3%)
New Permanent Pacemaker
21/75 (28%)
Case # 1 Data
79 years old women CC: “Severe aortic valve stenosis” HLP: porcelain aorta rheumatoid arthritis atrial fibrillation chronic renal failure
7th postoperative day
No peripheral vessel complication No stroke No PM indication Echo No
regurgitation No relevant gradient
DA-TAVI