全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...

Transcatheter Aortic Valve Implantation: Experience of Sainte Clotilde Hospital in Reunion Island

DOI: 10.4236/wjcd.2019.910069, PP. 772-780

Keywords: Calcified Aortic Stenosis, Percutaneous Valve Replacement, Sainte Clotilde Hospital, Reunion Island

Full-Text   Cite this paper   Add to My Lib

Abstract:

Introduction: Degenerative aortic stenosis is the most common valvulopathy in developed countries. The implantation of a percutaneous aortic valve (TAVI) has taken an important place in the management of this valvulopathy. The objective of this work is to report the results of patients treated by TAVI by the team of Sainte Clotilde Hospital (Reunion Island). Patients and?Methods: This was a descriptive retrospective study conducted from 01/10/2014?to 01/10/ 2017 in the Sainte Clotilde Hospital, Reunion Island. All patients who received TAVI for degenerative aortic stenosis were included in the study. Follow-up was completed until 31/08/19. Results: Forty-six (46) patients were included (sex ratio 0.53). The age was 82 (±7.5). Respectively,?56.5%, 21.7% and 6.5% of patients were diabetic [n = 26 (56.5%)], severe renal impairment [n = 10 (21.7%)] and hemodialysis [n = 3 (6.5%)]. All procedures were performed by femoral route under consious sedation. Edwards’ prostheses were used more often (93%), 100% Sapien 3, 6% of which were size 23. The primary success rate was 97.8% and the failure rate was 2% (deaths per procedure). The TAVI range of 0.66 ± 0.14 and 46.8 ± 15.5 against 1.48 ± 4.3 and 13.8 ± 5 in post TAVI. Severe pulmonary arterial?hypertension (>60 mmHg) was observed in 21.7% of pre-TAVI patients?compared to 4% in post TAVI patients. The overall rate of complications was 17% (n = 8). They were related to conductive disorders [6.5% (n = 3)], paraprosthetic leakage [2% (n = 1)], tamponade [2% (n = 1)], and hemorrhagic complications [6.5% (n = 3)]. Mean follow-up was 946 days (median = 1007.5 days), mean follow-up death rate was 30.4% (n = 14). The causes of death were non-cardiac in 57% (n = 8) of the cases. Conclusion: The TAVI results of the Sainte Clotilde Hospital Clinic are comparable to those observed in the

References

[1]  Baumgartner, H., Falk, V., Bax, J.J., et al. (2017) ESC/EACTS Guidelines for the Management of Valvular Heart Disease. European Heart Journal, 38, 2739-2791.
https://doi.org/10.1093/eurheartj/ehx391
[2]  Nishimura, R.A. (2002) Cardiology Patient Pages. Aortic Valve Diseas. Circulation, 106, 770-772.
https://doi.org/10.1161/01.CIR.0000027621.26167.5E
[3]  Baumbach, H., Ahad, S., Rustenbach, C., et al. (2017) Conventional versus Transapical Aortic Valve Replacement: Is It Time for Shift in Indications? The Thoracic and Cardiovascular Surgeon, 65, 212-217.
https://doi.org/10.1055/s-0036-1586491
[4]  Ludman, P.F., Moat, N., De Belder, M.A., et al. (2015) Transcatheter Aortic Valve Implantation in the United Kingdom: Temporal Trends, Predictors of Outcome, and 6-Year Follow-Up: A Report from the UK Transcatheter Aortic Valve Implantation (TAVI) Registry, 2007 to 2012. Circulation, 131, 1181-1190.
https://doi.org/10.1161/CIRCULATIONAHA.114.013947
[5]  Allahwala, U.K., Hansen, P.S., Danson, E.J., et al. (2016) Transcatheter Aortic Valve Implantation: Current Trends and Future Directions. Future Cardiology, 12, 69-85.
https://doi.org/10.2217/fca.15.73
[6]  Bouma, B.J., et al. (1999) To Operate or Not on Elderly Patients with Aortic Stenosis: The Decision and Its Consequences. Heart, 82, 143-148.
https://doi.org/10.1136/hrt.82.2.143
[7]  Iung, B., et al. (2003) A Prospective Survey of Patients with Valvular Heart Diseases in Europe: The Euro Heart Survey on Valvular Heart Disease. European Heart Journal, 24, 1231-1243.
https://doi.org/10.1016/S0195-668X(03)00201-X
[8]  Vahanian, A., et al. (2012) Guidelines on the Management of Valvular Heart Disease (Version 2012) the Joint Task on the Management of Valvular Heart Disease of European Society of Cardiology and European Association for Cardio-Thoracic Surgery. European Heart Journal, 33, 2451-2496.
[9]  Stewart, B.F., et al. (1997) Clinical Factors Associated with Calcific Aortic Valve Disease. Cardiovascular Health Study. Journal of the American College of Cardiology, 29, 630-634.
https://doi.org/10.1016/S0735-1097(96)00563-3
[10]  Neylon, A., Ahmed, K., Mercanti, F., Sharif, F. and Mylotte, D. (2018) Trans Catheter Aortic Valve Implantation: Status Update. Journal of Thoracic Disease, S3637- S3645.
https://doi.org/10.21037/jtd.2018.10.34
[11]  Smith, C.R., Leon, M.B., Mack, M.J., et al. (2011) Transcatheter versus Surgical Aortic-Valve Replacement in High-Risk Patients. The New England Journal of Medicine, 364, 2187-2198.
https://doi.org/10.1056/NEJMoa1103510
[12]  Adams, D.H., Popma, J.J., Reardon, M.J., et al. (2014) Transcatheter Aortic-Valve Replacement with a Self-Expanding Prosthesis. The New England Journal of Medicine, 370, 1790-1798.
https://doi.org/10.1056/NEJMoa1400590
[13]  Leon, M.B., Smith, C.R., Mack, M.J., et al. (2016) Transcatheter or Surgical Aortic-Valve Replacement in Intermediate-Risk Patients. The New England Journal of Medicine, 374, 1609-1620.
https://doi.org/10.1056/NEJMoa1514616
[14]  Leon, M.B., et al. (2010) Transcatheter Aortic Valve Implantation for Aortic Stenosis in Patients Who Cannot Undergo Surgery. The New England Journal of Medicine, 363, 1597-1607.
https://doi.org/10.1056/NEJMoa1008232
[15]  Thyregod, H.G.H., et al. (2015) Transcatheterversus Surgical Aortic Valve Replacement in Patients with Severe Aortic Valve Stenosis: 1-Year Results from the All- Comers NOTION Randomized Clinical Trial. Journal of the American College of Cardiology, 65, 2184-2194.
[16]  Deeb, G.M., et al. (2016) 3-Year Otcoumes in High-Risk patients Who Underwent Surgical or Transcatheter Aortic Valve Replacement. Journal of the American College of Cardiology, 67, 2565-2574.
[17]  Siontis, G.C.M., et al. (2016) Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement for Treatment of Severe Aortic Stenosis: A Meta-Analysis of Randomized Trials. European Heart Journal, 37, 3503-3512.
https://doi.org/10.1093/eurheartj/ehw225
[18]  Reardon, M.J., et al. (2017) Surgical or Transcatheter Aortic Valve Replacement in Intermediate-Risk Patients. The New England Journal of Medicine, 376, 1321-1331.
[19]  Siontis, G.C., Praz, F., Pilgrim, T., et al. (2016) Implantation de la valve aortiquetranscathéter par rapport au remplacement chirurgical de la valve aortique pour le traitement de la sténoseaortiquesévère: Uneméta-analysed’essaisrandomisés. European Heart Journal, 37, 3503-3512.
[20]  Auffret, V., et al. (2017) Temporal Trends in Transcatheter Aortic Valve Replacement in France: France 2 to France TAVI. Journal of the American College of Cardiology, 70, 42-55.
[21]  Stortecky, S., Brinks, H., Wenaweser, P., Huber, C., Pilgrim, T., Windecker, S., et al. (2011) Transcatheter Aortic Valve Implantation or Surgical Aortic Valve Replacement as Redo Procedure After Prior Coronary Artery Bypass Grafting. The Annals of Thoracic Surgery, 92, 1324-1331.
https://doi.org/10.1016/j.athoracsur.2011.05.106
[22]  Ducrocq, G., Al-Attar, N., Himbert, D., Messika-Zeitoun, D., Iung, B., Descoutures, F., et al. (2012) Early and Mid-Term Outcomes in Patients Undergoing Transcatheter Aortic Valve Implantation after Previous Coronary Artery Bypass Grafting. European Journal of Cardio-Thoracic Surgery, 41, 499-504.
https://doi.org/10.1093/ejcts/ezr041
[23]  Gandji, W., Azarnoush, K., Mulliez, A., Innorta, A., Farhat, M., Combaret, N., et al. (2016) Impact des techniques interventionnellesdans le traitement de la valvulopathieaortique après revascularisationmyocardiquechirurgicalepréalable. Annales de Cardiologie et d’Angéiologie, 65, 7-14.
https://doi.org/10.1016/j.ancard.2015.01.006
[24]  Athappan, G., Gajulapalli, R.D., Tuzcu, M.E., et al. (2016) Une revue systématiquesur la sécurité des valvulesaortiquestranscathéter de deuxièmegénération. EuroInterven- tion, 11, 1034-1043.
https://doi.org/10.4244/EIJV11I9A211
[25]  Feldman, T.E., Reardon, M.J., Rajagopal, V., et al. (2018) Effet du remplacementvalvulaireaortiquetranscathéter par expansion mécaniqueou auto-expansible sur la mortalité et les événementscliniquesindésirablesmajeurs chez les patients à haut risqueatteints de sténoseaortique: Essaicliniquerandomisé REPRISE III. The Journal of the American Medical Association, 319, 27-37.
[26]  Reardon, M.J., Van Mieghem, N.M., Popma, J.J., et al. (2017) Remplacementvalvulaireaortique chirurgical outranscathéter chez les patients à risqueintermédiaire. The New England Journal of Medicine, 376, 1321-1331.
https://doi.org/10.1056/NEJMoa1700456
[27]  Gilard, M., Eltchaninoff, H., Donzeau-Gouge, P., et al. (2016) Late Outcomes of Transcatheter Aortic Valve Replacement in High-Risk Patients: The FRANCE-2 Registry. Journal of the American College of Cardiology, 68, 1637-1647.
[28]  Carroll, J.D. (2016) TAVR Prognosis, Aging, and the Second TAVR Tsunami: Insights from France. Journal of the American College of Cardiology, 68, 1648-1650.
https://doi.org/10.1016/j.jacc.2016.08.005

Full-Text

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133