Clinical outcomes with transcatheter aortic valve implantation at a single cardiac center in Saudi Arabia.

BACKGROUND

Transcatheter aortic valve implantation (TAVI) has been recognized as a valid alternative to surgery for severe aortic valve stenosis (AS) in high-risk surgical patients.

OBJECTIVE

Determine first-year clinical outcomes for TAVI at Madinah Cardiac Center (MMC) in Saudi Arabia.

DESIGN

Retrospective, analytical cross-sectional.

SETTING

Tertiary cardiac care center.

PATIENTS AND METHODS

All patients who underwent TAVI for severe AS between February 2013 and December 2016 were included. Clinical, imaging, and laboratory information at baseline and at one year follow-up were analyzed.

MAIN OUTCOME MEASURES

Clinical and echocardiography out.comes at discharge, at 1-month, and at end of follow-up; one-year mortality, complications and clinical response to TAVI procedure.

SAMPLE SIZE AND CHARACTERISTICS

N=80, mean (SD) age 79.5 (10.6) years, with severe AS and high-surgical risk.

RESULTS

Fifty-five (69.2%) patients received Core valves, and 25 (30.8%) received Edward valves. Peri-procedure mortality was 3.8% and 1-year post-operative mortality was 13.8%. Ten patients (12.5%) had life-threatening or major bleeding. Nineteen (23.8%) patients had vascular complications, which were mostly minor. Fourteen patients (17.5%) developed acute kidney injury and 86% of these patients recovered. Five patients (6.25%) had pericardial effusion. Two patients (2.5%) developed endocarditis and another 2 patients (2.5%) had cerebrovascular accidents. Five patients (6.25%) received pacemakers. Mean aortic valve gradient significantly reduced from a mean (SD) 47.6 (19) mm Hg to 10.7 (6.0) mm Hg (P less than .001). New York Heart Association functional class was significantly reduced (P less than .001).

CONCLUSION

The TAVI experience at MCC is encouraging and comparable to international outcomes in terms of success, morbidity, and mortality rate.

LIMITATIONS

Retrospective, relatively small sample size. Rate of minor bleeding was overestimated.

CONFLICT OF INTEREST

None.