Percutaneous Aortic Valve Replacement for the Treatment of Aortic Stenosis. Early Experience in Brazil

Background: Percutaneous aortic valve replacement for the treatment of aortic stenosis is an available and efficient alternative for patients at high surgical risk, especially those with advanced age and comorbidities. Objective: The authors report the first experience made in our midst with the use of the CoreValve endoprosthesis. Methods: In January 2008, two patients underwent percutaneous aortic valve replacement due to symptomatic aortic stenosis. They were selected for being elderly (77 and 87 years) and presenting comorbidities and a high surgical risk (EuroScore 7.7 % and 12.1%). Results: Percutaneous implantations of the CoreValve device were successfully performed. Enlargement of the valve area (from 0.7 to 1.5 cm2 and from 0.5 to 1.3 cm2) and reduction of the aortic transvalvular gradient (from 82 to 50 mmHg and from 94 to 31 mmHg) were observed immediately after the intervention. During hospital stay, permanent pacemaker implantation was required in both patients due to atrioventricular block. At six months, an even greater drop in the aortic transvalvular gradient (gradient < 20 mmHg) and remission of symptoms of heart failure (NYHA III to NYHA I) were observed. Conclusion: The use of the CoreValve endoprosthesis for the treatment of aortic stenosis proved to be feasible and showed encouraging results in this early experience made in our midst. (Arq Bras Cardiol 2007;88(6):624-628) Key words: Aortic valve stenosis/therapy; balloon dilatation; heart valve prosthesis