Transapical aortic valve implantation

Abstract

Aim. To analyze the first results of transcatheter aortic valve implantation on the basis of the municipal hospital. Material and methods. The clinical material consists of 12 patients operated in municipal clinical hospital №15. Mean age was 73.9 (59—81) years. There were 8 men and 4 women. Inclusion criteria were calcified aortic valve (calcification degree 3) with predominant stenosis, EuroSCORE risk of traditional surgery more than 20%, dimension of fibrous ring of aortic valve 22.5— 25 mm, hemodynamically insignificant lesion of the coronary arteries and no other significant cardiac and aortic diseases. Results. According to the echocardiographic data systolic pressure gradient ranged from 53 to 138 mm Hg (mean 86±11 mm Hg). The diameter of the aortic fibrous ring was 22.5—25 mm. Effective orifice area of aortic valve was 0.6—0,9 cm² (mean 0.72± 0,2 cm²). There was tricuspid aortic valve in all patients. In 7 cases transcatheter aortic valve implantation via transapical approach was performed in view of iliac-femoral segment lesion. Stentless aortic prosthesis Edwards Sapien was installed in all patients. In the immediate postoperative period there was one death due to occlusion of the left coronary artery by prosthesis.