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Objective: Re-operations in patients (pts) with previous open heart surgery is challenging with an increased risk of adverse events and mortality. Aim of this study was to analyse, if transcatheter aortic valve implantation (TAVI) following cardiac surgery bears increased risks compared to TAVI without previous heart operation.
Methods: Between 01/2008 and 11/2011 a total of 133 pts underwent transapical TAVI. Of these, 43 pts (32.3%) had previous open heart surgery (group A) and 90 pts had no previous cardiac operations (group B). In group A 30 pts had CABG, 8 pts had aortic valve replacement (of these 4 pts Homograft-AVR), 2 pts had HTx and 3 pts had mitral valve operations prior to TAVI. Mean age was 76.1±9.5 yrs in group A and 81.4±7.4 yrs in group B (p<0.001). The logistic EuroScore was 30.2±19.0 in group A and 22.8±14.1 in group B (p=0.018).
Results: Operation time was 110±39min in group A and 108±43min in group B (p=0.899). Valves used were Edwards Sapien (Group A: 40 pts; Group B 89 pts) and Medtronic CoreValve (Group A 3 pts; Group B 1 pt). In group A 2 pts (one valve dislocation, one valve dysfunction) and in group B 3 pts (one valve dislocation, 2 apical bleedings) needed conversion to sternotomy. Actuarial survival after 1, 2 and 3 yrs were 92.7%, 88.8% and 84.4% in group A and 84.4%, 82.4% and 82.4% in group B (p = 0.501), respectively.
Conclusions: Both groups demonstrated good mid-term results after TAVI. Age but not previous heart surgery had negative influence on outcome after TAVI.