Transcutanous aortic valve replacement with Medtronic CoreValve in a publicprivate partnership hospital complex

Abstract

526Transcutanous aortic valve replacement with Medtronic CoreValve in a publicprivate partnership hospital complex both death and hospitalisation. Reported 30 day mortality ranges from 5 -15% (9-13) with 1 year survival ranging from 60 -80%. (8,10,(14)(15)(16) Improvement in symptomatology and valvular hemodynamic were also sustained at 2 years of follow-up. (10,13,16) The long-term durability of TAVI valves still has to be ascertained, but the 3 -5 year results are promising. (15 INTRODUCTIONIn the developed world, aortic stenosis (AS) is the most frequent type of valvular heart lesion found in the elderly. It primarily presents as calcific aortic stenosis in adults of advanced age above 65 years. (1,2) In asymptomatic individuals with severe AS, average event-free survival at 2 years ranges from 20 -50%. However, in symptomatic patients the prognosis is dismal with survival rates of 15 -50% at 5 years. (3)(4)(5) Aortic valve replacement is the definitive therapy for severe AS.However, many patients with AS and coexisting conditions are not candidates for surgical aortic valve replacement. In the Euro Heart Survey 33% of 216 patients >75 years presenting with symptomatic severe AS were not referred for surgery. (6) Transcatheter aortic valve implantation (TAVI) is an alternative, less invasive treatment for high risk patients with symptomatic severe AS. In the absence of anatomical contraindications, transfemoral approach is the preferred access route with a procedural success rate of >95%. (7)(8)(9)(10) In selected patients, TAVI reduced the rates of