COREVALVE EXTREME RISK: Promising results with CoreValve in very high-risk patients

Percutaneous aortic valve implantation ( TAVI ) recently demonstrated its superiority over medical treatment in patients with severe aortic stenosis and high surgical risk. Furthermore patients receiving TAVI showed a survival surgery equivalent to one year. This study included 471 patients with symptomatic severe aortic stenosis discarded of surgery due  a very high risk. The primary objective was to evaluate the safety and efficacy of self-expanding CoreValve prosthesis implanted by Ilio femoral access to this special group of patients.

All patients were evaluated by a “heart team” and had a mortality rate greater than 50% estimated with conventional surgery. After one year there was a 25.5 % decrease in mortality from all causes in relation to expectations for medical treatment ( calculated for the group receiving medical treatment in the PARTNER study and meta-analysis of several studies ). The pacemaker implant rate was 22% and moderate aortic insufficiency over 11 %, with the latter point , a progressive reduction along the track . Only severe aortic regurgitation was correlated with adverse outcomes . Neither age nor gender had an impact on results.

Original title: COREVALVE EXTREME RISK: A Prospective Registry Study of Transcatheter Aortic Valve Replacement with a Self-Expanding Transcatheter Heart Valve in Patients with Severe Aortic Stenosis