OBJECTIVES: To evaluate the outcome of transapical aortic valve implantation (TA-AVI) in comparison to conventional surgery.
METHODS:Â One hundred consecutive high-risk patients with symptomatic aortic valve stenosis received TA-AVI using the Edwards SAPIENâ„¢ pericardial xenograft between February 2006 and January 2008. Patient age was 82.7 Â± 5 years, 77 were females, logistic EuroSCORE predicted risk of mortality was 29.4 Â± 13% and Society Thoracic Surgeons score risk for mortality was 15.2 Â± 8.3%. Propensity score analysis was used to identify a control group of patients that underwent conventional aortic valve replacement (C-AVR).
RESULTS: Transapical aortic valve implantation was performed successfully in 97 patients, whereas three patients required early conversion. There were no new onset neurological events in the TA-AVI group and early extubation was performed in 82 patients. Echocardiography revealed good valve function with low transvalvular gradients in all patients. Thirty-day survival was 90 Â± 3 vs. 85 Â± 4% for TA-AVI vs. C-AVR, and 1-year survival was 73 Â± 4 vs. 69 Â± 5% (P = 0.55).
CONCLUSIONS: Transapical aortic valve implantation is a safe, minimally invasive, and off-pump technique to treat high-risk patients with aortic stenosis. Results of the initial 100 patients are good and compare favourably to conventional surgery.