329 Patient selection and learning curve influence the results of transapical aortic valve implantation

ObjectivesWhat influence do patient selection and learning curve have on the results of transapical aortic valve implantation (TAVI)?MethodsFrom September 2007 to January 2009, 33 patients treated with TAVI for severe symptomatic aortic stenosis were included in a prospective registry. According to their risk profile, 2 patient groups were distinguished. In Group 1 (n=25) the high surgical risk was related to technical difficulties for conventional aortic valve replacement (porcelain aorta, redo surgery with patent coronary artery bypass grafts, hi-dose mediastinal radiotherapy). In Group 2 (n=8) the high risk was due to severe comorbidities.ResultsTAVI was successfully performed in all patients without per-procedural death or stroke. “Valve in valve” reimplantation was necessary in 2 patients due to persistent leaks. Mean follow-up was 10.8 months (1-17). Overall mortality was 16% in Group 1and 37.5% in Group 2 (p=0.03). Predictive factors of hospital mortality were: NYHA class (p=0.03), LV dysfunction (p=0.009) and pulmonary hypertension (p