Publication: Ten years experience of transcatheter aortic valve replacement at the faculty of medicine siriraj hospital: Transapical vs transfemoral approach
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Issued Date
2021-05-01
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ISSN
01252208
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2-s2.0-85106379700
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Mahidol University
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SCOPUS
Bibliographic Citation
Journal of the Medical Association of Thailand. Vol.104, No.5 (2021), 846-852
Suggested Citation
Nattawut Wongpraparut, Pranya Sakiyalak, Decho Jakrapanichakul, Adisak Maneesai, Narathip Chunhamaneewat, Worawong Slisatkorn, Vithaya Chaithiraphan, Roongthip Chanwanitkulchai, Prayuth Rasmeehiran, Sirichai Jamnongprasatporn, Asa Phichaphop, Korakoth Towashiraporn, Pariya Panchavinnin, Chunhakasem Chotinaiwattarakul, Prasert Sawasdiwipachai, Kitima Kangawat, Rungtiwa Pongakasira Ten years experience of transcatheter aortic valve replacement at the faculty of medicine siriraj hospital: Transapical vs transfemoral approach. Journal of the Medical Association of Thailand. Vol.104, No.5 (2021), 846-852. doi:10.35755/jmedassocthai.2021.05.12353 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/78230
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Title
Ten years experience of transcatheter aortic valve replacement at the faculty of medicine siriraj hospital: Transapical vs transfemoral approach
Author(s)
Nattawut Wongpraparut
Pranya Sakiyalak
Decho Jakrapanichakul
Adisak Maneesai
Narathip Chunhamaneewat
Worawong Slisatkorn
Vithaya Chaithiraphan
Roongthip Chanwanitkulchai
Prayuth Rasmeehiran
Sirichai Jamnongprasatporn
Asa Phichaphop
Korakoth Towashiraporn
Pariya Panchavinnin
Chunhakasem Chotinaiwattarakul
Prasert Sawasdiwipachai
Kitima Kangawat
Rungtiwa Pongakasira
Pranya Sakiyalak
Decho Jakrapanichakul
Adisak Maneesai
Narathip Chunhamaneewat
Worawong Slisatkorn
Vithaya Chaithiraphan
Roongthip Chanwanitkulchai
Prayuth Rasmeehiran
Sirichai Jamnongprasatporn
Asa Phichaphop
Korakoth Towashiraporn
Pariya Panchavinnin
Chunhakasem Chotinaiwattarakul
Prasert Sawasdiwipachai
Kitima Kangawat
Rungtiwa Pongakasira
Other Contributor(s)
Abstract
Objective: To compare 30 days mortality and clinical outcomes between transapical transcatheter aortic valve replacement (TA-TAVR) and transfemoral transcatheter aortic valve replacement (TF-TAVR) in Thai patients who underwent transcatheter aortic valve replacement (TAVR). Materials and Methods: The observational study included 83 consecutive patients that attended the authors center for TAVR between January 2009 and December 2019. The patients baseline demographic data and surgical risks were recorded. The clinical outcomes at 30 days and one year were prespecified targets. Results: Eighty-Three patients underwent TAVR at the authors center between 2009 and 2019, with 77% of them considered inoperable or at high surgical risk by the authors heart team. Of the 83 patients, 40 had a porcelain aorta (48.2%). The median Society of Thoracic Surgeons (STS) score and logistic EuroSCORE were 5.7 (4.6, 8.3) and 21.7 (15.2, 31.2), respectively. Twenty-Two patients had a transapical approach (26.5%). The cardiovascular (CV) mortality rate was 2.4% at 30 days. The all-cause mortality 30-day rate and 1-year rate were 3.6% and 12.0%, respectively. Comparing between TA-TAVR and TF-TAVR, TA-TAVR had a significantly lower incidence of new permanent pacemaker placement after TAVR (p=0.032), but a longer length of hospital stay (p=0.087). There was a trend for a higher incidence of new onset atrial fibrillation in TA-TAVR. The all-cause mortality 30-day rate and 1-year rate were similar between TA-TAVR and TF-TAVR. Conclusion: In Thai symptomatic severe aortic stenosis patients, of whom most patients were considered inoperable or at high surgical risk, both TA-TAVR and TF-TAVR showed acceptable short-and long-Term clinical outcomes.