Faculty Collaboration Database

Transcatheter aortic valve implantation in patients with ascending aortic dilatation: safety of the procedure and mid-term follow-up†. Eur J Cardiothorac Surg 2014 Aug;46(2):228-33; discussion 233

Date

01/15/2014

Pubmed ID

24420370

DOI

10.1093/ejcts/ezt594

Scopus ID

2-s2.0-84905496389 (requires institutional sign-in at Scopus site)   27 Citations

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.

Author List

Rylski B, Szeto WY, Bavaria JE, Walsh E, Anwaruddin S, Desai ND, Moser W, Herrmann HC, Milewski RK

Author

Saif Anwaruddin MD Associate Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Aged, 80 and over
Aorta
Aortic Valve Stenosis
Dilatation, Pathologic
Female
Follow-Up Studies
Humans
Kaplan-Meier Estimate
Male
Transcatheter Aortic Valve Replacement
Treatment Outcome