Author + information
- Received January 17, 2014
- Revision received April 17, 2014
- Accepted April 24, 2014
- Published online October 1, 2014.
- Daniel Wendt, MD, PhD∗∗ (, )
- Philipp Kahlert, MD, PhD†,
- Susanne Pasa, MD∗,
- Karim El-Chilali, MD†,
- Fadi Al-Rashid, MD†,
- Konstantinos Tsagakis, MD∗,
- Daniel Sebastian Dohle, MD∗,
- Raimund Erbel, MD, PhD†,
- Heinz Jakob, MD, PhD∗ and
- Matthias Thielmann, MD, PhD∗
- ∗Department of Thoracic and Cardiovascular Surgery, West-German Heart Center Essen, University Hospital Essen, Germany
- †Department of Cardiology, West-German Heart Center Essen, University Hospital Essen, Essen, Germany
- ↵∗Reprint requests and correspondence:
Dr. Daniel Wendt, West-German Heart Department of Thoracic and Cardiovascular Surgery Center Essen, University Hospital Essen, Hufelandstraße 55, 45122 Essen, Germany.
Objectives This study sought to evaluate the self-expandable ACURATE TA device (Symetis SA, Ecublens, Switzerland) in a cohort of patients with pure aortic regurgitation (AR).
Background Transcatheter aortic valve replacement (TAVR) has been initially considered as an alternative for high-risk patients with aortic stenosis. Although the current experience is limited, TAVR might be also an alternative to treat patients with pure, severe AR.
Methods Between April 2012 and December 2013, a total of 8 high-risk patients with pure, severe AR were enrolled (grade III+). Clinical and hemodynamic data as well as data on device and procedure parameters and outcomes were collected.
Results Patient mean was 72.5 ± 8.4 years, and 37.5% of patients were female. Logistic EuroSCORE was 34.0 ± 7.9% and the Society of Thoracic Surgeons score was 7.3 ± 3.3% on average. Two patients had undergone emergency aortic operation before due to acute type A aortic dissection, and both were treated by replacement of the ascending aorta (including root reconstruction) and the aortic arch combined with or without E-vita Open stent graft (Jotec GmbH, Hechingen, Germany) (January 2011 and March 2012), whereas the other patients experienced primary AR. All patients underwent successful transapical TAVR with the transapical ACURATE TA device (size small, n = 1, size medium, n = 3, size large, n = 4) without any intraprocedural complications according to the Valve Academic Research Consortium 2 criteria. Post-procedure AR grade I+ or lower, as revealed by transoesophageal echocardiography and angiography, was present in all 8 patients. At 30 days, the stroke incidence and all-cause mortality rate were 0%.
Conclusions This small single-center series demonstrates the feasibility of transapical TAVR with the self-expandable ACURATE TA device in high-risk patients with severe AR.
Drs. Kahlert and Wendt are proctors for Edwards Lifesciences. Dr. Thielmann is a proctor for Symetis SA. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received January 17, 2014.
- Revision received April 17, 2014.
- Accepted April 24, 2014.
- American College of Cardiology Foundation