Abstract| Volume 23, ISSUE 10, SUPPLEMENT , S22, October 2017

Clinical Outcomes of TAVI for Aortic Stenosis Patients with Impaired Cardiac Function

      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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