[Transcatheter aortic valve implantation: surgeon's view]

  • Bleiziffer S
  • Bauernschmitt R
  • Ruge H
 et al. 
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Abstract

BACKGROUND AND PURPOSE: The technology of catheter- based aortic valve implantation is a new, less invasive therapeutic option for patients with symptomatic high-grade aortic stenosis. The present paper aims to demonstrate that optimal therapy should be provided by a multidisciplinary team consisting of cardiac surgeons, cardiologists and cardioanesthesiologists in a hybrid suite. PATIENTS AND METHODS: From June 2007 to April 2009, 234 patients have been treated by transcatheter aortic valve implantation through different access sites (n = 168 femoral artery, n = 56 left ventricular apex, n = 7 subclavian artery, n = 3 ascending aorta) at the German Heart Center Munich, Germany. An algorithm for the choice of the most appropriate access site for the individual patient was established. RESULTS: The 30-day mortality was 11.2% in this high-risk patient cohort. A certain number of periprocedural complications required surgical management. There was a considerable clinical improvement of the patients 6 months after the procedure. CONCLUSION: Integrating the new methods of aortic valve implantation into a cardiac surgery program, all kinds of surgical and interventional treatment options may be offered to the patient with aortic stenosis by one multidisciplinary team. A qualified and safe performance of transcatheter aortic valve implantation and the management of potential complications require the presence of a hybrid suite.

Author-supplied keywords

  • Aged, 80 and over
  • Aortic Valve Stenosis/*mortality/*surgery
  • Female
  • Germany/epidemiology
  • Heart Catheterization/*mortality
  • Heart Valve Prosthesis Implantation/*mortality
  • Heart Valve Prosthesis/*utilization
  • Humans
  • Male
  • Patient Care Team
  • Prevalence
  • Survival Analysis
  • Survival Rate

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Authors

  • S Bleiziffer

  • R Bauernschmitt

  • H Ruge

  • D Mazzitelli

  • C Schreiber

  • A Hutter

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