Experience and learning curve with transapical aortic valve implantation

Transapical transcatheter aortic valve implantation has emerged as an alternative to conventional aortic valve replacement in high-risk patients with degenerative aortic valve stenosis. The aim of this study was to assess a potential learning curve with the former technique based on the own experien...

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Published in:Herz 2009-08, Vol.34 (5), p.388-397
Main Authors: Wendt, Daniel, Eggebrecht, Holger, Kahlert, Philipp, Heine, Torsten, Kottenberg, Eva, Massoudy, Parwis, Kamler, Markus, Peters, Jürgen, Erbel, Raimund, Jakob, Heinz, Thielmann, Matthias
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Language:ger
Subjects:
Aged, 80 and over
Aortic Valve Stenosis - mortality
Aortic Valve Stenosis - surgery
Cardiac Catheterization - mortality
Clinical Competence - statistics & numerical data
Female
Germany - epidemiology
Heart Valve Prosthesis - utilization
Heart Valve Prosthesis Implantation - mortality
Humans
Male
Patient Care Team
Practice Patterns, Physicians' - statistics & numerical data
Prevalence
Survival Analysis
Survival Rate
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container_issue 5
container_start_page 388
container_title Herz
container_volume 34
creator Wendt, Daniel
Eggebrecht, Holger
Kahlert, Philipp
Heine, Torsten
Kottenberg, Eva
Massoudy, Parwis
Kamler, Markus
Peters, Jürgen
Erbel, Raimund
Jakob, Heinz
Thielmann, Matthias
description Transapical transcatheter aortic valve implantation has emerged as an alternative to conventional aortic valve replacement in high-risk patients with degenerative aortic valve stenosis. The aim of this study was to assess a potential learning curve with the former technique based on the own experience with this novel procedure. 40 consecutive high-risk patients (82 +/- 5 years, logistic EuroSCORE 42% +/- 16%) with symptomatic aortic valve stenosis underwent transapical aortic valve implantation (balloon expandable Sapien bioprosthesis, Edwards Lifesciences, Irvine, CA, USA) in the hybrid operating room between October 2007 and May 2009 at the West German Heart Center Essen. To assess a potential learning curve, patients were allocated and compared according to the implantation date (initial n = 20: 10/2007 to 10/2008; second n = 20: 11/2008 to 05/2009). All but one transapical aortic valve implantations were successful (procedural success rate 97.5%) and no prosthesis migration/embolization or coronary artery obstruction was observed. Comparing the groups, procedural time, fluoroscopy time, and contrast media volume decreased significantly (139 +/- 30 min vs. 112 +/- 41 min; 6.8 +/- 1.9 min vs. 5.5 +/- 1.5 min; 226 +/- 75 ml vs. 169 +/- 23 ml; p
doi_str_mv 10.1007/s00059-009-3265-y
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subjects Aged, 80 and over
Aortic Valve Stenosis - mortality
Aortic Valve Stenosis - surgery
Cardiac Catheterization - mortality
Clinical Competence - statistics & numerical data
Female
Germany - epidemiology
Heart Valve Prosthesis - utilization
Heart Valve Prosthesis Implantation - mortality
Humans
Male
Patient Care Team
Practice Patterns, Physicians' - statistics & numerical data
Prevalence
Survival Analysis
Survival Rate
title Experience and learning curve with transapical aortic valve implantation
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