Valvular Heart DiseaseFeasibility and Safety of Transcatheter Aortic Valve Implantation Performed Without Intensive Care Unit Admission
Section snippets
Methods
Between December 2014 and July 2015, all consecutive patients who underwent TAVI in our center were included in a monocentric prospective study. Exclusion criteria included valve-in-valve procedures and transaortic or transapical approaches. The procedures were performed in the catheterization laboratory using the new-generation balloon-expandable Edwards SAPIEN 3 bovine pericardial device (Edwards Lifesciences, Irvine, California) or the self-expandable CoreValve porcine pericardial device
Results
The study enrolled 177 patients, 61 (34.5%) were classified in the low-risk group and 116 (65.5%) in the high-risk group according to the predefined criteria. Except for the risk factors in the criteria defining low- versus high-risk groups in our study, the clinical characteristics between the groups of patients only differed by the logistic EuroSCORE (p = 0.011; Table 3). Most TAVIs were performed under general anesthesia with orotracheal intubation (n = 170, 96.1%) and with transfemoral
Discussion
The main results of this study were as follows: (1) TAVI may be performed safely without subsequent ICU admission using simple patient and procedural selection criteria; (2) postprocedural complications included mainly conductive disorders with a very low rate of major vascular and bleeding events; (3) the main predictive factors of complications in our study included preprocedural RBBB, self-expandable prosthesis implantation, use of VKA therapy, and conductive disorders occurring during the
Acknowledgment
We thank Valérie Macioce for her help in reading the manuscript and correcting English language.
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