EFFICACY AND SAFETY OF SINGLE STAGE ENDOVASCULAR INTERVENTIONS WITH TRANSCATHETER IMPLANTING OF AORTIC VALVE

Transcatheter implanting of aortic valve (TIAV) in critical aortic stenosis is a separate manipulation requiring thorough preparation. Among patients with critical aortic stenosis from a group of endovascular correction, there is a high prevalence of comorbid atherosclerotic lesions in coronary, carotid arteries, and other pathologies, manageable only interventionally.

Aim. To assess the efficacy and safety of single-moment performing of TIAV and additional endovascular interventions.

Material and methods. From the year 2011, in our clinic endovascular implanting of aortic valve was done for 125 patients with aortic valve dysfunction, in 51% (64 patients) had coronary, renal and carotid arteries lesion, aneurysmatic dilation of abdominal aorta. In 31 (48%) cases together with endovascular valve placement additionally endovascular interventions were done.

Results. Technical success was reached in all 125 cases. In-patient mortality from all causes was 7.2% (9 patients), with no significant difference between combination treatment group and other patients. In 2 cases there was stenting done, of coronary and carotid arteries (with 1 case of coronary, carotid and renal arteries), as single step. In one patient there was endovascular prevention done of ischemic complications of permanent atrial fibrillation by implanting of the system Watchman (Boston Scientific, USA) and stenting of coronary arteries; in one case a single step endoprosthesing of abdominal aorta was done and coronary stenting. In concomitant interventions group there was no myocardial infarction and no significant difference in cerebrovascular events between groups.

Conclusion. TIAV can be followed by single step addition of endovascular procedures if the surgical team and clinics has good experience, and with thorough planning of operation and post-surgery period.

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