Transcatheter Aortic Valve Implantation: Early Experience in Korea

Background and Objectives: Transcatheter aortic valve implantation (TAVI) was recently introduced in Korea. The present report describes the experience of early TAVI cases. Subjects and Methods: Between March, 2010 and October, 2011, 48 patients with severe symptomatic aortic stenosis (AS) were screened at the Asan Medical Center to determine their suitability for surgical intervention. Of these, 23 were considered unsuitable and underwent TAVI. Procedural success rates, procedurerelated complications, and clinical outcomes were evaluated in the TAVI patients. Results: Transfemoral (n=20) or transapical (n=3) TAVI was performed. The mean age of patients was $75.9{\pm}5.4$ years and 57% were females. The mean logistic European System for Cardiac Operative Risk Evaluation was $25.6{\pm}5.1%$. Implantation was successful in 22 patients (19 transfemoral, three transapical). After successful implantation, the mean aortic valve area increased from $0.68{\pm}0.14cm^{2}$ to $1.45{\pm}0.33cm^{2}$. There were no procedure-related complications or mortality. The patients showed no paravalvular aortic regurgitation with ${\geq}$ moderate degree and remained stable without progression during follow-up. During follow-up (interquartile range, 1.1-12.9), all patients were alive without any occurrence of valve failure. Conclusion: TAVI procedure is feasible in patients with inoperative symptomatic AS leading to hemodynamic and clinical improvement. With accumulation of experience, proper patient selection and development of device technologies, TAVI should decrease adverse events and expand the indications in the near future.