P296 What if Cardiac Surgeons Perform Trans–catheter Aortic Valve Interventions?

Abstract

Background and aim Aim of this study is to present the results of our aortic valve interventions program embedding surgical (SAVR) and trans–catheter treatment, both in the hands of cardiac surgeons. Methods Data of patients who had isolated aortic valve interventions during the period 2016–2022 were reviewed. SAVR was performed mainly through a minimally invasive approach . TAVI included either TF or TA access procedures, all performed in a cardiac surgery theatre with fluoroscopy equipment. Results During the study period, 1435 patients underwent isolated aortic valve intervention: 1022 surgical AVR (665 mini AVR, 357 FS) and 413 TAVI (333 TF and 80 TA). TAVI were introduced during 2018 and gained a wider application over the years with the progressive adoption of awake procedures and fully percutaneous access (Figure 1). The global volume of aortic valve procedures increased of 38% comparing the full–years 2021 with 2018 (295 vs 213 cases). Multivariable logistic regression showed that TAVI was significantly associated with increased age, female gender, a higher rate of comorbidities and lower LVEF. Overall in–hospital mortality was 0.6% – mini AVR 0.3%, FS 0.3%, TF TAVI 1% and TA TAVI 3%. Permanent neurologic injury was recorded in 0.7% of the patients. Permanent PM implantation was higher after TAVI (87/413 vs 32/1022 patients who had surgical AVR). Conclusions TAVI procedures can be safely performed by cardiac surgeons. The expertise in both surgical and trans–catheter treatment translated in the possibility of treating aortic valve disease in a higher volume of patients including older and comorbid patients with excellent early results.