Clinical and hemodynamic outcomes of “all-comers” undergoing transapical aortic valve implantation: Results from the Italian Registry of Trans-Apical Aortic Valve Implantation (I-TA)

Abstract

TA-TAVI represents a safe and effective alternative treatment for patients who are inoperable or at high risk for surgery. The occurrence of an intraoperative complication significantly affects survival. Procedural volume and learning curve have no impact on patient survival.

Complications of transcatheter aortic valve implantation (TAVI): how to avoid and treat them

“…Within the SOURCE registry summarising 1394 transapical cases, only five (0.4%) severe events (apical tear or rupture) have been reported 8. A similar rate of severe intraoperative bleeding events (0.8%) has been described in the Italian Transapical Registry 9. Hence, the apical access itself can be considered safe.…”

Echocardiographic Imaging of Procedural Complications During Balloon-Expandable Transcatheter Aortic Valve Replacement

“…A recent meta-analysis of transapical TAVR studies revealed the following incidence of major adverse events: 30-day mortality (4.7% to 20.8%), cerebrovascular accident (0.0% to 16.3%), major tachyarrhythmia (0.0% to 48.8%), bradyarrhythmia requiring permanent pacemaker insertion (0.0% to 18.7%), cardiac tamponade (0% to 11%), major bleeding (1% to 17%), myocardial infarction (0% to 6%), aortic dissection/rupture (0% to 5%), moderate to severe paravalvular leak (0.7% to 24.0%), cardiopulmonary bypass support (0% to 15%); conversion to surgery (0.0% to 9.5%), and valve-in-valve implantation (0.6% to 8.0%) (111). Numerous studies suggest that the learning curve in this procedure may play a significant role in outcomes (47,112,113). …”

Clinical Outcomes After Transcatheter Aortic Valve Replacement Using Valve Academic Research Consortium Definitions

“…This has resulted in a substantial number of published case series, registries, and, lately, randomized controlled trials (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). Diversity in technique and study devices as well as disparity in the learning curve may potentially explain some of the discrepancies in outcomes that have been reported.…”