Early and Long-Term Results of 101 Consecutive Patients After Transcarotid Transcatheter Aortic Valve Implantation

Abstract

Background/Objectives: Transcatheter aortic valve implantation through the common carotid artery (TC-TAVI) is one of the possible treatment options for patients with ineligible transfemoral approach. The aim of our study was to evaluate the efficacy and safety of patients treated with TC-TAVI in early and long-term follow-up. Methods: The study included patients with severe aortic stenosis treated with TC-TAVI. In-hospital outcomes, early, long-term follow-up were presented in accordance with the VARC-3 recommendations. Results: The analysis presented 101 patients. We observed high procedural success-97% (n = 98). The number of VARC-3 incidents: 3.96% major vascular complications; 0.99% myocardial infarction; 0.99% cardiac tamponade; 0.99% life-threatening bleeding; 3.96% cerebrovascular incidents. The NYHA class decreased significantly compared to the pre-procedure value (2 [1–2] vs. 3 [3–3]; p < 0.001). There was a significant improvement in postprocedural cerebral oximetry values compared to baseline on both the implanted and contralateral sides (67.5 [63–71]% vs. 70 [63.5–75]%; p < 0.05) and (67 [64–71]% vs. 71 [64–76]%; p < 0.05), respectively. The 30-day, 1-year, and 2-year survival rates were 94.1%, 80.2%, and 69.3%, respectively. In the univariate analysis, BAV (HR 4.54; 95% CI: 1.14–17.99; p = 0.03) and LVEF ≤ 35% (HR 7.32; 95% CI: 2.59–20.65; p < 0.001) were significantly associated with two-year mortality. In an exploratory adjusted Cox regression analysis, BAV (HR 2.63; 95% CI: 1.07–6.45; p = 0.03) and LVEF ≤ 35% (HR 3.48; 95% CI: 1.67–7.24; p < 0.001) were associated with higher 2-year mortality. Conclusions: Our single-center, observational report indicated feasibility and good observed outcomes of the TC-TAVI procedure in an experienced clinical team.