Percutaneous Self-Expanding Aortic Valve Prosthesis In Patients With Severe Aortic Stenosis And High Surgical Risk. French Single Center Experience

Introduction. The degenerative aortic stenosis is the most common valve pathology in Western countries; when symptomatic the treatment is surgical replacement of the valve. One third of symptomatic patients are not operated because of high surgical risk. A percutaneous treatment is currently available for these patients.Objectives. The aim of this study was to valuate the feasibility, efficacy, and short and medium term results of percutaneous self-expanding valve CoreValve r implantation in patients with symptomatic severe aortic stenosis (area < 1 cm(2)) and high surgical risk (EuroSCORE > 20%).Material and methods. In this prospective single center study were included 54 patients, mean age 84 +/- 8 years, aortic valve area 0.78 +/- 0.23 cm(2) and EuroSCORE of 27.5% +/- 15. The approach was percutaneous by femoral access, or surgical by iliac or subclavian access. Before the implantation, balloon valvuloplasty was performed. The valve was positioned and deployed retrogradelly. Follow-up was done at 30 days and 6 months.Results. The procedural success rate was 98%. The peak echocardiographic gradient decreased from 70 +/- 23 to 17 +/- 6 mmHg, and valvular area increased to 2.01 cm(2). In-hospital and 30 days mortality was 5.5% and 9.8% respectively, and 6 months survival rate was 76%.Conclusions. The percutaneous valve CoreValve r implantation is a feasible and effective technique, with acceptable short and mid-term results in patients with severe symptomatic aortic stenosis and high surgical risk.