Introduction: Degenerative aortic stenosis is the most common valvulopathy in developed countries. The implantation of a percutaneous aortic valve (TAVI) has taken an important place in the management of this valvulop...Introduction: Degenerative aortic stenosis is the most common valvulopathy in developed countries. The implantation of a percutaneous aortic valve (TAVI) has taken an important place in the management of this valvulopathy. The objective of this work is to report the results of patients treated by TAVI by the team of Sainte Clotilde Hospital (Reunion Island). Patients and?Methods: This was a descriptive retrospective study conducted from 01/10/2014?to 01/10/ 2017 in the Sainte Clotilde Hospital, Reunion Island. All patients who received TAVI for degenerative aortic stenosis were included in the study. Follow-up was completed until 31/08/19. Results: Forty-six (46) patients were included (sex ratio 0.53). The age was 82 (±7.5). Respectively,?56.5%, 21.7% and 6.5% of patients were diabetic [n = 26 (56.5%)], severe renal impairment [n = 10 (21.7%)] and hemodialysis [n = 3 (6.5%)]. All procedures were performed by femoral route under consious sedation. Edwards’ prostheses were used more often (93%), 100% Sapien 3, 6% of which were size 23. The primary success rate was 97.8% and the failure rate was 2% (deaths per procedure). The TAVI range of 0.66 ± 0.14 and 46.8 ± 15.5 against 1.48 ± 4.3 and 13.8 ± 5 in post TAVI. Severe pulmonary arterial?hypertension (>60 mmHg) was observed in 21.7% of pre-TAVI patients?compared to 4% in post TAVI patients. The overall rate of complications was 17% (n = 8). They were related to conductive disorders [6.5% (n = 3)], paraprosthetic leakage [2% (n = 1)], tamponade [2% (n = 1)], and hemorrhagic complications [6.5% (n = 3)]. Mean follow-up was 946 days (median = 1007.5 days), mean follow-up death rate was 30.4% (n = 14). The causes of death were non-cardiac in 57% (n = 8) of the cases. Conclusion: The TAVI results of the Sainte Clotilde Hospital Clinic are comparable to those observed in the literature.展开更多
The association between aortic insufficiency and sinus dysfunction is rare. We reported a case of significant chronic degenerative aortic insufficiency associated with sinus dysfunction. This was a 66-year-old patient...The association between aortic insufficiency and sinus dysfunction is rare. We reported a case of significant chronic degenerative aortic insufficiency associated with sinus dysfunction. This was a 66-year-old patient on follow-up for asymptomatic chronic aortic insufficiency who was referred to us for a preoperative invasive hemodynamic assessment. The indication for surgery was based on the left ventricular dilation criteria. The echocardiography and cardiac catheterization showed a disappearance between the aortic insufficiency and the left ventricular repercussion. Upon discovery of the sinus bradycardia, the patient received a single chamber pacemaker set at a base rate of 70 seconds in AAIR at first and then the patient was measured remotely. At five months, cardiac pacing resulted in a significant reduction in the left ventricular diameter and volume on the echocardiography and magnetic resonance imaging;therefore surgery was postponed.展开更多
文摘Introduction: Degenerative aortic stenosis is the most common valvulopathy in developed countries. The implantation of a percutaneous aortic valve (TAVI) has taken an important place in the management of this valvulopathy. The objective of this work is to report the results of patients treated by TAVI by the team of Sainte Clotilde Hospital (Reunion Island). Patients and?Methods: This was a descriptive retrospective study conducted from 01/10/2014?to 01/10/ 2017 in the Sainte Clotilde Hospital, Reunion Island. All patients who received TAVI for degenerative aortic stenosis were included in the study. Follow-up was completed until 31/08/19. Results: Forty-six (46) patients were included (sex ratio 0.53). The age was 82 (±7.5). Respectively,?56.5%, 21.7% and 6.5% of patients were diabetic [n = 26 (56.5%)], severe renal impairment [n = 10 (21.7%)] and hemodialysis [n = 3 (6.5%)]. All procedures were performed by femoral route under consious sedation. Edwards’ prostheses were used more often (93%), 100% Sapien 3, 6% of which were size 23. The primary success rate was 97.8% and the failure rate was 2% (deaths per procedure). The TAVI range of 0.66 ± 0.14 and 46.8 ± 15.5 against 1.48 ± 4.3 and 13.8 ± 5 in post TAVI. Severe pulmonary arterial?hypertension (>60 mmHg) was observed in 21.7% of pre-TAVI patients?compared to 4% in post TAVI patients. The overall rate of complications was 17% (n = 8). They were related to conductive disorders [6.5% (n = 3)], paraprosthetic leakage [2% (n = 1)], tamponade [2% (n = 1)], and hemorrhagic complications [6.5% (n = 3)]. Mean follow-up was 946 days (median = 1007.5 days), mean follow-up death rate was 30.4% (n = 14). The causes of death were non-cardiac in 57% (n = 8) of the cases. Conclusion: The TAVI results of the Sainte Clotilde Hospital Clinic are comparable to those observed in the literature.
文摘The association between aortic insufficiency and sinus dysfunction is rare. We reported a case of significant chronic degenerative aortic insufficiency associated with sinus dysfunction. This was a 66-year-old patient on follow-up for asymptomatic chronic aortic insufficiency who was referred to us for a preoperative invasive hemodynamic assessment. The indication for surgery was based on the left ventricular dilation criteria. The echocardiography and cardiac catheterization showed a disappearance between the aortic insufficiency and the left ventricular repercussion. Upon discovery of the sinus bradycardia, the patient received a single chamber pacemaker set at a base rate of 70 seconds in AAIR at first and then the patient was measured remotely. At five months, cardiac pacing resulted in a significant reduction in the left ventricular diameter and volume on the echocardiography and magnetic resonance imaging;therefore surgery was postponed.
