Transcatheter aortic valve implantation in patients with ascending aortic dilatation: safety of the procedure and mid-term follow-up†.
Publication/Presentation Date
8-1-2014
Abstract
OBJECTIVES: Transcatheter aortic valve implantation (TAVI) does not enable concomitant or simultaneous ascending aortic intervention. This investigation evaluates the safety of TAVI in patients with ascending aortic dilatation and demonstrates mid-term follow-up.
METHODS: From November 2007 to December 2012, among 1143 patients with severe aortic stenosis screened for TAVI, a cohort of 457 patients met the inclusion criteria. Of these, a total of 98 patients [71% males, median age 85.0 (9.0) years] were diagnosed with concomitant ascending aortic dilatation (4.0-5.0 cm). An additional 2 patients had an ascending aortic diameter of >5.0 cm. The mid-term follow-up (652.2 patient-years) was 100% complete.
RESULTS: There was no iatrogenic dissection in patients with dilatated ascending aorta. Intraoperative aortic rupture occurred in 1 patient with mildly dilatated ascending aorta. One-year survival rates in patients with dilatated and non-dilatated ascending aorta were 65 of 75 (87%) and 201 of 242 (83%, P = 0.573). The mean ascending aortic diameter remained stable at 4.1 (0.2) and 4.7 (0.2) cm in patients with mild and moderate dilatation, respectively, with a median follow-up of 14 months after TAVI. Two patients with an aortic diameter of over 5.0 cm survived the procedure and expired 7 and 20 months after TAVI due to tumour and heart failure, respectively.
CONCLUSIONS: Ascending aortic dilatation is diagnosed in almost one-fourth of patients treated with TAVI. Their intraprocedural risk of adverse aortic events is low. The ascending aortic dilatation does not affect mid-term survival in the TAVI population.
Volume
46
Issue
2
First Page
228
Last Page
233
ISSN
1873-734X
Published In/Presented At
Rylski, B., Szeto, W. Y., Bavaria, J. E., Walsh, E., Anwaruddin, S., Desai, N. D., Moser, W., Herrmann, H. C., & Milewski, R. K. (2014). Transcatheter aortic valve implantation in patients with ascending aortic dilatation: safety of the procedure and mid-term follow-up†. European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 46(2), 228–233. https://doi.org/10.1093/ejcts/ezt594
Disciplines
Medicine and Health Sciences
PubMedID
24420370
Department(s)
Department of Surgery
Document Type
Article