PRINCE SULTAN CARDIAC CENTER ALHASA TAVI EXPERIENCE AND CHALLENGES Dr. Abdullah Ghabashi 10th GHA and SHA24 (16 Feb 2013)
Overview • • • • • •
Planning Starting Maintain Expanding Our first year Experience Summary Conclusion
Planning
Functioning Heart Team at PSCCH
Functioning TAVI team in PSCCH
“The only source of knowledge is experience.” Albert Einstein PROCTORSHI PROCTORSHI PP
Maintaining the program
CV surgery Concerns of surgical AVR
Surgical AVR before and after starting TAVI Program
Expanding the program
PRINCE SULTAN CARDIAC CENTER ALHASA EXPERIENCE
Patients Baseline Characterestics Total Patients
N= (25)
Age
81 Âą 10
Male Gender
60% (20)
DM
52% (13)
HTN
68% (17)
Renal Impairment
24% (6)
COPD
16% (4)
Patients Baseline Characterestics Total Patients
N= (25)
Previous CABG
20% (5)
IHD diagnosis
56% (19)
PCI done pre-TAVI
44% (11)
AVA pre-TAVI
0.68 ±0.6
EuroScore
24.3 ± 9.2
EF
48 ± 9.7
Total Paients
N= (25)
Trans-Femoral
76% (19)
Trans-Aortic
20% (5)
Trans-Apical
4% (1)
23mm Edward XT
80% (20)
26mm Edward XT
20% (5)
Successful Implant
92% (23)
30 days Outcome • One death within 24hrs • One Stroke • One Trans-Apical patient had 2 valves implanted for AR due to positioning • NO major Vascular Complications • One Prostar Failure (Cut-down) • One patient had PPM
NYHA FC (NB- CP and Syncope)
Conclusion • It takes a team work for a successful TAVI program • Appropriate patient selection is the key. • UNKNOWNS -----agree on it by heart team consensus • Follow the evolving technology to improve outcomes • Err on the caution side
With WithPermission Permission
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