Transcatheter Aortic Valve Implantation: A Single-Center Experience of 300 Cases

Background: Transcatheter aortic valve implantation (TAVI) has recently become an alternative to surgical aortic valve replacement in Selected patients with high operative risk. Objectives: To investigate the 30 day clinical outcome of the first 300 consecutive patients treated with transfemoral TAVI at the Tel Aviv Medical Center. Methods: The CoreValve was used in 250 patients and the Edwards-Sapien valve in 50. The mean age of the patients was 83 +/- 5.3 years (range 63-98 years) and the mean Valve area 0.69 +/- 0.18 cm(2) (range 0.3-0.9 cm(2)); 62% were women. Results: The procedural success rate was 100%, and 30 day follow-up was done in all the patients. The average Euro-score for the cohort was 26 +/- 13 (range 1.5-67). Total in-hospital mortality and 30 day mortality were both 2.3% (7 patients). Sixty-seven patients (22%) underwent permanent pacemaker implantation after the TAVI procedure, mostly due to new onset of left bundle brunch block and prolonged PR interval or to high degree atrioventricutar block. The rate of stroke was 1.7% (5 patients). Forty-one patients (13.7%) had vascular complications, Of whom 9 (3%) were defined as major Vascular complications (according to the VARC definition). Conclusions: The 30 day clinical outcome in the first 300 consecutive TAVI patients in Our center was favorable, with a mortality rate of 2.3% and low rates of stroke (1.7%) and major vascular complications (3%).