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Povzetek: Aim To determine the procedural characteristics, results, and long-term outcomes of the first 500 consecutive patients undergoing transcatheter aortic valve implantation (TAVI) at the MC Medicor International Center for Cardiovascular Diseases Izola (Slovenia). Methods Data were collected from the institutional registry. The date of death was obtained from the National BIRPIS system by using the patient’s health insurance card number. The difference in 30-day mortality was assessed between two consecutive cohorts of 250 patients, patients who received self-expandable (SEV) and those with balloon-expandable (BEV) valves, and between patients ≤80 and >80 years old. Results Between December 2016 and September 2023, 500 patients (80 ± 6 years, 52% men, EuroScore II, 4.09 ± 4.11), including 3.2% with degenerated surgical prosthesis, underwent TAVI. After predilatation (57%), SEV was implanted in 87.5% and BEV in 12.5% of the patients. The mean postprocedural gradient was 10 ± 4 mm Hg, with more than moderate regurgitation in 0.4%. Emergency cardiac/vascular surgery was performed in 1.4%, and stroke occurred in 0.8%. The new permanent pacemaker (PPM) rate decreased from 19% to 7% (P < 0.001) in the second cohort, and the mean postprocedural transaortic gradient was significantly lower after SEV compared with BEV (9 ± 4 vs 13 ± 4 mm Hg; P < 0.001). There was no difference in 30-day mortality between the first and second cohort of 250 patients (1.2% vs 1.2%; P = 1.000), cohorts of 50 patients from number 0 to 500 (0% vs 2.0%; P = 0.391), SEV and BEV groups (0.9% vs 1.6%; P = 0.487), and patients ≤80 and >80 years old (2.0% vs 0.4%; P = 0.119). Conclusion TAVI results in our study are comparable with international standards. PPM rate decreased over time, and postprocedural gradient was lower after SEV. Learning curve, type of valve, and patient age did not affect 30-day mortality.
Ključne besede: aortic valve, transcatheter implantation, retrospective study
Objavljeno v DiRROS: 05.06.2026; Ogledov: 279; Prenosov: 215
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Povzetek: Background: There is a lack of studies systematically addressing long-term echocardiographic features after patent foramen ovale (PFO) closure. Thus, the present study investigated long-term echocardiographic features after percutaneous closure of PFO. Methods: This was a single-centre observational study based on the institutional registry of consecutive patients undergoing PFO closure. Clinical and echocardiographic features during the follow-up were investigated. Results: Between 2006 and 2023, 355 consecutive patients underwent PFO closure following transitory ischaemic attack (TIA) or cerebrovascular insult (CVI). Echocardiography immediately after the procedure and at 6 months was performed in 306 (86%) patients, who had repeat examinations at either between 1 and 5 years (median 1.32 years), between 5 and 10 years (median 7.10 years) or after 10 years (median 11.64 years). The percentage of patients with complete closure (no bubbles during the Valsalva manoeuvre) increased from 64% after the procedure to 80% at 6 months (p<0.05), and ranged between 77% and 81% thereafter (NS). Functional closure (≤10 bubbles) was observed in 93% of patients after the procedure and remained between 94% and 97% thereafter (NS). Except for decreased immediate complete closure (60% versus 83%; p<0.001), there was no difference between the Amplatzer PFO occluder and alternative devices. Among the 15 patients with greater than moderate residual shunt, reasons for the shunt were determined in 73% of patients and included leakage at the level of device, fenestration/atrial septal defect and pulmonary arteriovenous malformation. There was no late device embolisation, thrombus formation or pericardial effusion. Clinical follow-up revealed recurrent TIA and CVI rates of 0.11 and 0.06 per 100 patient-years, respectively. Conclusion: We demonstrated high (>90%) and persistent functional PFO closure beyond 10 years, independent of closure device. There was no late device embolisation, thrombus formation or pericardial effusion. Favourable echocardiographic features were associated with very low rates of recurrent TIA or CVI.
Ključne besede: patent foramen ovale closure, residual shunt, echocardiography
Objavljeno v DiRROS: 01.06.2026; Ogledov: 374; Prenosov: 261
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