Transcatheter aortic valve implantation experience at the University Hospital Centre Zagreb and University Hospital Centre Rijeka.

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Cardiologia Croatica
2016;11(3-4):131.
VII. nacionalni sastanak o kardiovaskularnim intervencijama s međunarodnim sudjelovanjem
VI. sastanak intervencijskih kardioloških medicinskih sestara i tehničara
Transcatheter aortic valve implantation (TAVI) has been shown to be adequate modality for treatment
of high risk or inoperable patients with severe symptomatic aortic stenosis. In this abstract data con-
cerning TAVI from 2 Croatian University Hospital Centers Zagreb and Rijeka are presented.
In tota l 51 TAVI were prefo r med in thes e institutions (29 UHC Zag reb vs . 22 UHC Rijeka). All de cision s re-
garding performing TAVI instead surgical aortic valve replacement (SAVR) were made by “heart team”.
Of all patients, 30 (58.8%) were female and overall average age was 79.94 years. Mean European System
for Cardiac Operative Risk Evaluation (EuroSCORE) was 9.95 and Society of Thoracic Surgeons (STS)
mortality score 5.29. Average maximal gradient across valve before TAVI was 92 mmHg with average
aortic valve area 0.65cm2. 40% of patient had coronary artery disease and all of those were treated
either with coronary artery bypass graft surgery or percutaneous coronary intervention prior to TAVI.
In two patients (3.92%) valve-in-valve procedure was done. Almost all possible approaches were used
(transapical, trans -carotid, -subclavian, direct aortic) but majority of procedures were performed us-
ing transfemoral approach (88%), from which 51.9% were done using surgical closure of femoral artery,
while in rest of the cases Proscar was used. Valve was successfully implanted in 96% of cases. In one
patient TAVI had to be converted in rescue SAVR. In 6 cases (11.76%) procedure was complicated with
femoral artery bleeding and in one case (1.96%) with retroperitoneal bleeding. After the procedure 6
patients (11.76%) developed atrioventricular block requiring permanent pacemaker implantation. Two
patients (3.92%) developed stroke and one (1.96%) developed myocardial infarction. Overall in hospital
mortality was 5.88%, and one-year mortality was 4.17%.
When compared to data in larger registries1 our results are almost the same and in some cases even
better. In conclusion TAVI is adequate treatment option for selected patient in Croatia and we strongly
encourage performing it even more in the future.
Joško Bulum1*,
Vjekoslav Tomulić2,
Maja Strozzi1,
David Gobić2,
Ivica Šafradin1,
Igor Medved2,
Jadranka Šeparović
Hanževački1,
Višnja Ivančan1,
Zvonimir Ostojić1
1 University of Zagreb School of
Medicine, University Hospital
Centre Zagreb, Zagreb, Croatia
2 University of Rijeka School of
Medicine, University Hospital
Centre Rijeka, Rijeka, Croatia
KEYWORDS: aortic stenosis, transcatheter aortic valve implantation, complications.
CITATION: Cardiol Croat. 2016;11(3-4):131. | DOI: http://dx.doi.org/10.15836/ccar2016.131
*ADDRESS FOR CORRESPONDENCE: Joško Bulum, Klinički bolnički centar Zagreb, Kišpatićeva 12,
HR-10000 Zagreb, Croatia. / Phone: +385-98-171-4090 / E-mail: jbulum@gmail.com
ORCID: Joško Bulum, http://orcid.org/0000-0002-1482-6503 • Vjekoslav Tomulić, http://orcid.org/0000-0002-3749-5559
Maja Strozzi, http://orcid.org/0000-0003-4596-8261 • David Gobić, http://orcid.org/0000-0001-9406-1127
Ivica Šafradin, http://orcid.org/0000-0003-4519-5940 • Igor Medved, http://orcid.org/0000-0002-5847-2698
Jadranka Šeparović Hanževački, http://orcid.org/0000-0002-3437-6407 • Višnja Ivančan, http://orcid.org/0000-0002-7282-9753
Zvonimir Ostojić, http://orcid.org/0000-0003-1762-9270
Transcatheter aortic valve implantation experience at the
University Hospital Centre Zagreb and University Hospital Centre
Rijeka
LITERATURE
1. Holmes D R Jr, Brennan JM, Rums feld JS, Dai D, O’B rien SM, Vemulapal li S, et al; STS/ACC TV T Registry. Clini cal outcomes at 1 ye ar following
transcatheter aortic valve replacement. JAMA. 2015;313(10):1019-28. DOI: http://dx.doi.org/10.1001/jama.2015.1474
Extended Abstract STRUCTURAL HEART DISEASE INTERVENTIONS
RECEIVED:
February 9, 2016
ACCEPTED:
February 20, 2016