Purpose
Transcatheter aortic valve implantation (TAVI) has become a method of choice in repair of valvular aortic stenosis,
especially in group of patients with high surgical risk.
Purpose of our study was to determine thepossibilities of multislice computed tomography (MSCT) in planning of TAVI.
To definethe access path of TAVI,
size and type of aortic valve prosthesis.
Methods and Materials
Sixtyfive patients with severe aortic stenosis and multiple comorbidities at median age of 77 years were included.All patients had severe aortic stenosis.
According to the echo an average gradient of systolic pressure on the aortic valve before the operation was 76,3 ± 22,5 mm Hg.
All patients were in III-IV functional class by NYHA.
Each having at least one concomitant disease seriously affecting the status
The risk of conventional open repair was >20% by EuroSCORE and > 10% by STS.
MSCT angiography of coronary and...
Results
The possibility of TAVI procedure was estimated due to the results of MSCT measurements. In 34 casesTAVI was performed through transfemoral access,
in 18 patients - via transapical access,
and in 1 patient – direct transaortic approach was used.
10 patients were excluded due to specific anatomy of annulus and femoral arteries kinking.
Intraoperative mortality was 1.9%: 1 patient (women) died with symptoms of acute heart failure.
2 patient died within 7 days after TAVI from myocardial infarction and other 2 patients developed cardiogenic shock....
Conclusion
TAVI has become a method of choice in repair of valvular aortic stenosis in group of patients with high surgical risk.
MSCTin planning of TAVI is obligatory procedure,
which allows to exclude patients with specific anatomy and preciselyselect the access path,size and type of aortic valve prothesis.
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