Original articleAdult cardiacMedium Term Outcomes of Transapical Aortic Valve Implantation: Results From the Italian Registry of Trans-Apical Aortic Valve Implantation
Section snippets
Patients and Methods
This study represents an update of our previously published paper with data from the Italian Registry of Trans-Apical Aortic Valve Implantation (I-TA) [5]. The I-TA registry is a prospective, independent, and spontaneous registry with the participation of the majority of Italian cardiac surgery centers who started a TA-TAVI program. All patients undergoing TA-TAVI at each center were enrolled in this registry. From April 2008 through June 2012, 774 patients underwent TA-TAVI at 21 centers.
Results
Preoperative clinical variables of patients are listed in Table 1. Mean age was 81.0 ± 6.7 years, mean logistic EuroSCORE I was 25.6% ± 16.3%; EuroSCORE II, 9.4% ± 11.0%; and STS score, 10.6% ± 8.5%. New York Heart Association (NYHA) functional class III or IV was assigned to 621 patients (80.2%). Nearly 50% of patients had severe peripheral vascular disease. There were 167 patients (21.6%) who had already undergone cardiac surgery, and 139 patients (18.0%) who had percutaneous coronary
Comment
This study shows the results of transapical TAVI in a “real world” population. Our main findings are that transapical TAVI can be performed with an acceptable mortality rate, safety at 30 days, efficacy at 1 year, as well as 3-year survival and freedom from cardiovascular mortality, in particular if we consider the high surgical risk of these patients. All-cause mortality was 9.9%; this value is similar to that reported by other registries 9, 10, 11. The 30-day combined safety endpoint is a
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