Abstract 4512: One-Year Clinical Outcome after Percutaneous Aortic Valve Implantation

Percutaneous Aortic Valve Replacement (PAVR) is increasingly being used to treat patients with aortic stenosis who are considered poor surgical candidates. Thirty-day mortality has been reported to vary between 12 and 20%. One study reported a one-year mortality of 18%. We sought to determine the one-year clinical outcome in the patients treated in two institutions by means of a prospective observational cohort study. Between November 2005 and May 2008, 81 patients with aortic stenosis and high surgical risk were treated with the CoreValve Revalving System. Predefined demographic, clinical, laboratory, echo and procedural variables were prospectively entered into a dedicated database. Prospective follow-up data were collected during out-patient clinic visits. Vital status was obtained by contacting the civil registries. Follow-up was complete for all patients. Mean ± SD age was 83 ± 6 years and 46 % were male. The mean logistic EuroSCORE was 17 ± 10. The baseline LV ejection fraction was 45 ± 13. Peak velocity (Mean ± SD) was 4.3 ± 0.8 m/sec pre-PAVR and was 2.0 ± 0.5 immediately post-PAVR. At 30 days, 4 patients (5%) died (cardiac tamponade during PAVR: 2 patients, sepsis 4 weeks after PAVR: 1 patient, subdural haematoma after an ill-fated fall during cardiac rehabilitation: 1 patient). PAVR was complicated by a stroke in 4 patients (5%) and by a myocardial infarction in 2 other patients (2%). The one-year mortality rate was 15%. In the present series of elderly patients treated with PAVR because of severe aortic stenosis, the 30-day mortality was only 3,8%. It was 15% at one year. In all patients, mortality was due to associated cardio-vascular disease. Clinically, there was no evidence of valve dysfunction.