Percutaneous implantation of self-expandable aortic valve in high risk patients with severe aortic stenosis: The first experiences in Serbia

Background/Aim. Aortic stenosis (AS) is the most common valvular heart disease in elderly people, with rather poor prognosis in symptomatic patients. Surgical valve replacement is the therapy of choice, but a significant number of patients cannot undergo surgical procedure. We presented...

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Main Authors: Nedeljković Milan A., Beleslin Branko, Tešić Milorad, Vukčević Vladan, Stanković Goran, Stojković Siniša, Orlić Dejan, Bilbija Ilija, Matković Miloš, Simić Tijana, Menković Nemanja, Mrdović Igor, Ussia Gian Paolo, Perišić Zoran, Babić Momčilo
Format: Article
Language:English
Published: Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade 2016-01-01
Series:Vojnosanitetski Pregled
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Online Access:http://www.doiserbia.nb.rs/img/doi/0042-8450/2016/0042-84501500024N.pdf
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author Nedeljković Milan A.
Beleslin Branko
Tešić Milorad
Vukčević Vladan
Stanković Goran
Stojković Siniša
Orlić Dejan
Bilbija Ilija
Matković Miloš
Simić Tijana
Menković Nemanja
Mrdović Igor
Ussia Gian Paolo
Perišić Zoran
Babić Momčilo
author_facet Nedeljković Milan A.
Beleslin Branko
Tešić Milorad
Vukčević Vladan
Stanković Goran
Stojković Siniša
Orlić Dejan
Bilbija Ilija
Matković Miloš
Simić Tijana
Menković Nemanja
Mrdović Igor
Ussia Gian Paolo
Perišić Zoran
Babić Momčilo
author_sort Nedeljković Milan A.
collection DOAJ
description Background/Aim. Aortic stenosis (AS) is the most common valvular heart disease in elderly people, with rather poor prognosis in symptomatic patients. Surgical valve replacement is the therapy of choice, but a significant number of patients cannot undergo surgical procedure. We presented initial experience of transcatheter aortic valve implantation (TAVI) performed in Catheterization Laboratory of the Clinic for Cardiology, Clinical Center of Serbia. Methods. The procedures were performed in 5 patients (mean age 76 ± 6 years, 2 males, 3 female) with severe and symptomatic AS with contraindication to surgery or high surgical risk. The decision to perform TAVI was made by the heart team. Pre-procedure screening included detailed clinical and echocardiographic evaluation, coronary angiography and computed tomography scan. In all the patients we implanted a self-expandable aortic valve (Core Valve, Medtronic, USA). Six months follow-up was available for all the patients. Results. All interventions were successfully performed without significant periprocedural complications. Immediate hemodynamic improvement was obtained in all the patients (peak gradient 94.2 ± 27.6 to 17.6 ± 5.2 mmHg, p < 0.001, mean pressure gradient 52.8 ± 14.5 to 8.0 ± 2.1 mmHg, p < 0.001). None of the patients developed heart block, stroke, vascular complication or significant aortic regurgitation. After 6 months, the survival was 100% with New York Heart Association (NYHA) functional improvement in all the patients. Conclusion. This successful initial experience provides a solid basis to treat larger number of patients with symptomatic AS and high surgical risk who are left untreated. [Projekat Ministarstva nauke Republike Srbije, br. ON 175 020]
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spelling doaj-art-2e0eb42bc1064d1bbb1fcb795bf4bc812025-08-20T03:18:30ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502406-07202016-01-0173219219710.2298/VSP141117024N0042-84501500024NPercutaneous implantation of self-expandable aortic valve in high risk patients with severe aortic stenosis: The first experiences in SerbiaNedeljković Milan A.0Beleslin Branko1Tešić Milorad2Vukčević Vladan3Stanković Goran4Stojković Siniša5Orlić Dejan6Bilbija Ilija7Matković Miloš8Simić Tijana9Menković Nemanja10Mrdović Igor11Ussia Gian Paolo12Perišić Zoran13Babić Momčilo14Clinical Center of Serbia, Clinic for Cardiology, Belgrade + Faculty of Medicine, BelgradeClinical Center of Serbia, Clinic for Cardiology, Belgrade + Faculty of Medicine, BelgradeClinical Center of Serbia, Clinic for Cardiology, Belgrade + Faculty of Medicine, BelgradeClinical Center of Serbia, Clinic for Cardiology, Belgrade + Faculty of Medicine, BelgradeClinical Center of Serbia, Clinic for Cardiology, Belgrade + Faculty of Medicine, BelgradeClinical Center of Serbia, Clinic for Cardiology, Belgrade + Faculty of Medicine, BelgradeClinical Center of Serbia, Clinic for Cardiology, Belgrade + Faculty of Medicine, BelgradeClinical Center of Serbia, Clinic for Cardiac Surgery, BelgradeClinical Center of Serbia, Clinic for Cardiac Surgery, BelgradeClinical Center of Serbia, Center for Anesthesiology and Reanimation, BelgradeClinical Center of Serbia, Clinic for Radiology, BelgradeClinical Center of Serbia, Clinic for Cardiology, Belgrade + Faculty of Medicine, BelgradeTor Vergata University of Rome, Department of Cardiovascular Disease, Rome, ItalyFaculty of Medicine, Clinical Center Niš, Clinic for Cardiovascular Diseases, NišNational Health Insurance Fund, BelgradeBackground/Aim. Aortic stenosis (AS) is the most common valvular heart disease in elderly people, with rather poor prognosis in symptomatic patients. Surgical valve replacement is the therapy of choice, but a significant number of patients cannot undergo surgical procedure. We presented initial experience of transcatheter aortic valve implantation (TAVI) performed in Catheterization Laboratory of the Clinic for Cardiology, Clinical Center of Serbia. Methods. The procedures were performed in 5 patients (mean age 76 ± 6 years, 2 males, 3 female) with severe and symptomatic AS with contraindication to surgery or high surgical risk. The decision to perform TAVI was made by the heart team. Pre-procedure screening included detailed clinical and echocardiographic evaluation, coronary angiography and computed tomography scan. In all the patients we implanted a self-expandable aortic valve (Core Valve, Medtronic, USA). Six months follow-up was available for all the patients. Results. All interventions were successfully performed without significant periprocedural complications. Immediate hemodynamic improvement was obtained in all the patients (peak gradient 94.2 ± 27.6 to 17.6 ± 5.2 mmHg, p < 0.001, mean pressure gradient 52.8 ± 14.5 to 8.0 ± 2.1 mmHg, p < 0.001). None of the patients developed heart block, stroke, vascular complication or significant aortic regurgitation. After 6 months, the survival was 100% with New York Heart Association (NYHA) functional improvement in all the patients. Conclusion. This successful initial experience provides a solid basis to treat larger number of patients with symptomatic AS and high surgical risk who are left untreated. [Projekat Ministarstva nauke Republike Srbije, br. ON 175 020]http://www.doiserbia.nb.rs/img/doi/0042-8450/2016/0042-84501500024N.pdfaortic valve stenosistranscatheter aortic valve replacementseverity of illness indexrisk factorscardiac surgical procedures
spellingShingle Nedeljković Milan A.
Beleslin Branko
Tešić Milorad
Vukčević Vladan
Stanković Goran
Stojković Siniša
Orlić Dejan
Bilbija Ilija
Matković Miloš
Simić Tijana
Menković Nemanja
Mrdović Igor
Ussia Gian Paolo
Perišić Zoran
Babić Momčilo
Percutaneous implantation of self-expandable aortic valve in high risk patients with severe aortic stenosis: The first experiences in Serbia
Vojnosanitetski Pregled
aortic valve stenosis
transcatheter aortic valve replacement
severity of illness index
risk factors
cardiac surgical procedures
title Percutaneous implantation of self-expandable aortic valve in high risk patients with severe aortic stenosis: The first experiences in Serbia
title_full Percutaneous implantation of self-expandable aortic valve in high risk patients with severe aortic stenosis: The first experiences in Serbia
title_fullStr Percutaneous implantation of self-expandable aortic valve in high risk patients with severe aortic stenosis: The first experiences in Serbia
title_full_unstemmed Percutaneous implantation of self-expandable aortic valve in high risk patients with severe aortic stenosis: The first experiences in Serbia
title_short Percutaneous implantation of self-expandable aortic valve in high risk patients with severe aortic stenosis: The first experiences in Serbia
title_sort percutaneous implantation of self expandable aortic valve in high risk patients with severe aortic stenosis the first experiences in serbia
topic aortic valve stenosis
transcatheter aortic valve replacement
severity of illness index
risk factors
cardiac surgical procedures
url http://www.doiserbia.nb.rs/img/doi/0042-8450/2016/0042-84501500024N.pdf
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