The subject of TAVI involves high-surgical risk patients including low EF. However,
efficacy of this treatment for such patients is still unknown. So, we reviewed clinical
outcomes of TAVI for patients with severe aortic stenosis (AS), complicated with impaired
cardiac function. We have experiences of 50 cases with low EF equal or less than 40%
in all 440 TAVI cases. In the cohort, the median of age was 83 years old. Twenty cases
(40%) was female, and STS-PROM was calculated as 11.05% at average. Urgent or emergency
cases were 14(28%). Used TAVI devices were SAPIEN in 37 patients (74%), CoreValve
in 10 (20%), Acurate in 3 (6%). Trans-femoral approach was chosen in 24 cases (48%),
and alternative approach in 26 cases (52%) Twenty patients (40%) required intended
ECMO support during the procedure. As a result, in all cases, procedural success was
achieved without any conversion to open heart surgery. Not-intended ECMO support was
needed in only one case because of instable hemodynamics. Thirty day mortality was
only one case (2%), and the reason for death was acute coronary syndrome. The incidence
of stroke was 0%. Kaplan-Meire curve of overall survival showed 87, 75, 75% at 1,
3, and 5 year postoperatively. TAVI for AS patients with cardiac dysfunction was very
feasible treatment option with acceptable early and mid-term outcomes.
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