ARYA Atherosclerosis Journal

Current Issue

By Issue

By Author

By Subject

Author Index

Keyword Index

About Journal

Aims and Scope

Editorial Board

Publication Ethics

Indexing and Abstracting

Related Links

FAQ

Peer Review Process

Journal Metrics

News

Early experience of transcatheter aortic valve implantation (TAVI) procedure in Isfahan, Iran

Document Type : Original Article

Authors

1 Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran

2 School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran

4 Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

5 Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

6 Chamran Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

7 Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

10.48305/arya.2025.43010.2995

Abstract

BACKGROUND: Valve replacement is an optional treatment for patients with severe aortic stenosis (AS) and is associated with a better prognosis and improved quality of life. However, surgical valve replacement may result in severe complications, especially in the elderly. Transcatheter aortic valve replacement (TAVR) for treating symptomatic aortic stenosis has expanded exponentially, becoming a therapeutic option for intermediate- and high-risk patients. To thoroughly examine and monitor its practices and improve outcomes, our TAVI center in Isfahan established a detailed registry as the primary center for the TAVI procedure.
METHODS: This prospective study was conducted among all patients who underwent the TAVR procedure from September 2022 to December 2023 in Isfahan. Baseline characteristics (demographic, clinical, and procedural), 30-day outcomes, and one-year mortality data were collected.
RESULTS: A total of 50 patients underwent the TAVI procedure in Isfahan during our registry. Of these, 56% were male, and the mean age was 77.8 ± 6.7 years. The mean calculated STS score was 5.6. Cardiac death occurred in 4 patients (8%), one (2%) experienced a major vascular complication, 5 (10%) required new pacemaker implantation, and acute kidney injury was observed in 14%. Fever/sepsis occurred in 16%, cardiac tamponade in 6%, one patient (2%) had moderate AI, two patients experienced coronary obstructions, and one suffered a major cerebrovascular accident. Additionally, 4 patients (8%) developed atrial fibrillation, 1 (2%) had ventricular tachycardia, and 6 (12%) experienced AV block.
CONCLUSION: We have shown good both 30-days outcome and one year mortality in our registry that could be a proper option in treating severe AS with comorbidities instead of surgical aortic valve replacement.

Keywords

References
1. Aronow WS, Ahn C, Kronzon I, Nanna M. Prognosis of congestive heart failure in patients aged > or = 62 years with unoperated severe valvular aortic stenosis. Am J Cardiol. 1993 Oct 1;72(11):846-8. https://doi.org/10.1016/0002-9149(93)91081-r
2. Guidelines on the management of valvular heart disease: The Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology. Eur Heart J. 2007 Jan;28(2):230-68. https://doi.org/10.1093/eurheartj/ehl428
3. Iung B, Cachier A, Baron G, Messika-Zeitoun D, Delahaye F, Tornos P, et al. Decision-making in elderly patients with severe aortic stenosis: why are so many denied surgery? Eur Heart J. 2005 Dec;26(24):2714-20. https://doi.org/10.1093/eurheartj/ehi471
4. Baumgartner H, Falk V, Bax JJ, De Bonis M, Hamm C, Holm PJ, et al. 2017 ESC/EACTS Guidelines for the management of valvular heart disease. Polish Heart Journal (Kardiologia Polska). 2018;76(1):1-62. https://doi.org/10.1093/eurheartj/ehx391
5. Makkar RR, Thourani VH, Mack MJ, Kodali SK, Kapadia S, Webb JG, et al. Five-Year Outcomes of Transcatheter or Surgical Aortic-Valve Replacement. N Engl J Med. 2020 Jan 29;382(9):799-809. https://doi.org/10.1056/nejmoa1910555
6. Smith CR, Leon MB, Mack MJ, Miller DC, Moses JW, Svensson LG, et al. Transcatheter versus surgical aortic-valve replacement in high-risk patients. N Engl J Med. 2011 Jun 9;364(23):2187-98. https://doi.org/10.1056/nejmoa1103510
7. Leon MB, Smith CR, Mack M, Miller DC, Moses JW, Svensson LG, et al. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med. 2010 Oct 21;363(17):1597-607. https://doi.org/10.1056/nejmoa1008232
8. Writing Group Members; Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, et al. Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. Circulation. 2016 Jan 26;133(4):e38-360. https://doi.org/10.1161/cir.0000000000000350
9. Eftychiou C, Eteocleous N, Zittis I, Simamonian K, Ioannou A, Loukaidou P, et al. Outcomes of transfemoral transcatheter aortic valve implantation (TAVI) and predictors of thirty-day major adverse cardiovascular events (MACE) and one-year mor-tality. Hellenic J Cardiol. 2021 Jan-Feb;62(1):57-64. https://doi.org/10.1016/j.hjc.2020.09.011
10. Kellum JA, Lameire N, Aspelin P, Barsoum RS, Burdmann EA, Goldstein SL, et al. Work group membership. Kidney Int. 2012;2(1):10.1038.
11. Kappetein AP, Head SJ, Généreux P, Piazza N, Van Mieghem NM, Blackstone EH, et al. Updated standardized endpoint definitions for transcatheter aortic valve implantation: the Valve Academic Research Consortium-2 consensus document. J Am Coll Cardiol. 2012 Oct 9;60(15):1438-54. https://doi.org/10.1016/j.jacc.2012.09.001
12. Zahn R, Gerckens U, Grube E, Linke A, Sievert H, Eggebrecht H, et al. Transcatheter aortic valve implantation: first results from a multi-centre real-world registry. Eur Heart J. 2011 Jan;32(2):198-204. https://doi.org/10.1093/eurheartj/ehq339
13. Eltchaninoff H, Prat A, Gilard M, Leguerrier A, Blanchard D, Fournial G, et al. Transcatheter aortic valve implantation: early results of the FRANCE (FRench Aortic National CoreValve and Edwards) registry. Eur Heart J. 2011 Jan;32(2):191-7. https://doi.org/10.1093/eurheartj/ehq261
14. Mack MJ, Leon MB, Thourani VH, Makkar R, Kodali SK, Russo M, et al. Transcatheter Aortic-Valve Replacement with a Balloon-Expandable Valve in Low-Risk Patients. N Engl J Med. 2019 May 2;380(18):1695-705. https://doi.org/10.1056/nejmoa1814052
15. Thourani VH, Kodali S, Makkar RR, Herrmann HC, Williams M, Babaliaros V, et al. Transcatheter aortic valve replacement versus surgical valve replacement in intermediate-risk patients: a propensity score analysis. Lancet. 2016 May 28;387(10034):2218-25. https://doi.org/10.1016/s0140-6736(16)30073-3
16. Piazza N, Grube E, Gerckens U, den Heijer P, Linke A, Luha O, et al. Procedural and 30-day outcomes following transcatheter aortic valve implantation using the third generation (18 Fr) corevalve revalving system: results from the multicentre, expanded evaluation registry 1-year following CE mark approval. EuroIntervention. 2008 Aug;4(2):242-9. https://doi.org/10.4244/eijv4i2a43
17. Takagi H, Hari Y, Kawai N, Ando T; ALICE (All-Literature Investigation of Cardiovascular Evidence) Group. Meta-Analysis of Impact of Anemia and Hemoglobin Level on Survival After Transcatheter Aortic Valve Implantation. Am J Cardiol. 2019 Jan 15;123(2):306-14. https://doi.org/10.1016/j.amjcard.2018.09.042
18. Sannino A, Schiattarella GG, Toscano E, Gargiulo G, Giugliano G, Galderisi M, et al. Meta-Analysis of Effect of Body Mass Index on Outcomes After Transcatheter Aortic Valve Implantation. Am J Cardiol. 2017 Jan 15;119(2):308-16. https://doi.org/10.1016/j.amjcard.2016.09.031
19. Barbash IM, Barbanti M, Webb J, Molina-Martin De Nicolas J, Abramowitz Y, Latib A, et al. Comparison of vascular closure devices for access site closure after transfemoral aortic valve implantation. Eur Heart J. 2015 Dec 14;36(47):3370-9. https://doi.org/10.1093/eurheartj/ehv417
20. Oguri A, Yamamoto M, Mouillet G, Gilard M, Laskar M, Eltchaninoff H, et al. Impact of chronic kidney disease on the outcomes of transcatheter aortic valve implantation: results from the FRANCE 2 registry. EuroIntervention. 2015 Jan;10(9):e1-9. https://doi.org/10.4244/eijv10i9a183
21. Siddiqui WJ, Alvarez C, Aslam M, Bakar A, Khan MH, Aslam A, et al. Meta-Analysis Comparing Outcomes and Need for Renal Replacement Therapy of Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement. Am J Cardiol. 2018 Aug 1;122(3):468-76. https://doi.org/10.1016/j.amjcard.2018.04.030
22. Tarantini G, Mojoli M, Urena M, Vahanian A. Atrial fibrillation in patients undergoing transcatheter aortic valve implantation: epidemiology, timing, predictors, and outcome. Eur Heart J. 2017 May 1;38(17):1285-93. https://doi.org/10.1093/eurhe artj/ehw456
23. Tarantini G, Mojoli M, Windecker S, Wendler O, Lefèvre T, Saia F, et al. Prevalence and Impact of Atrial Fibrillation in Patients With Severe Aortic Stenosis Undergoing Transcatheter Aortic Valve Replacement: An Analysis From the SOURCE XT Prospective Multicenter Registry. JACC Cardiovasc Interv. 2016 May 9;9(9):937-46. https://doi.org/10.1016/j.jcin.2016.01.037
24. Onorati F, D’Errigo P, Barbanti M, Rosato S, Covello RD, Maraschini A, et al. Different impact of sex on baseline characteristics and major periprocedural outcomes of transcatheter and surgical aortic valve interventions: Results of the multicenter Italian OBSERVANT Registry. J Thorac Cardiovasc Surg. 2014 May;147(5):1529-39. https://doi.org/10.1016/j.jtcvs.2013.05.039
ARYA Atherosclerosis Journal
Volume 21, Issue 2
March 2025
Pages 18-27
Files
Share
How to cite
Statistics