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Master Thesis

Évaluation clinique et échographique à long terme après implantation d’une valve aortique par voie percutanée

Abstract : Introduction: valve durability after transcatheter aortic valve implantation (TAVI) is an important issue since the increase of implantations and the extension of indications. This study aimed to assess long-­term evolution of all generations of percutaneous balloon-­expandable prostheses, predictive factors of valve deterioration and long-­term mortality. Material and methods: all patients with severe and symptomatic aortic stenosis hospitalized in Montpellier University Hospital from 2009 at 2014 for TAVI with a balloon-­expandable valve were included in this observational prospective study. Primary endpoint was the occurrence of death from acute heart failure or valvular deterioration defined by the international 2017 EAPCI-­‐ESC-­‐EACTS standardized definition. Results: with a median 3.4-­year follow-­up and a maximal follow-­up of 8 years, 203 consecutive patients were included. Median age was 85 years [IQR 79-­‐88], with 55.2% of women and a median logistic EuroSCORE of 14.4% [IQR 10.7-­‐23.2]. Mean aortic gradient decreased dramatically from 50.3±15.7mmHg before TAVI to 8.9±3.4mmHg after TAVI (p<0.0001) with a global stability up to 8 years independently of valve generation. Primary endpoint occurred in 29 patients (18.1%) with 9 cases of valvular deterioration (5.6%) without significant difference between first and latest valve generation. Survival rate was 12.9% at 8 years. Conclusion: valvular deterioration after balloon-­expandable TAVI is very low up to 8-­year follow-­up. In a high-­risk population, TAVI is a safe and durable alternative to surgery to treat aortic stenosis.
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Master Thesis
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Submitted on : Tuesday, May 18, 2021 - 4:22:15 PM
Last modification on : Monday, October 11, 2021 - 1:25:03 PM
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Alexandra Meilhac. Évaluation clinique et échographique à long terme après implantation d’une valve aortique par voie percutanée. Médecine humaine et pathologie. 2018. ⟨dumas-03018966⟩

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