SHA24/069002

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

Appendix