11th International Heart Conference

Scientific Program

AlMasri Hatem

KASH Cardiac Centre , Saudi Arabia

Title: Surgical aor c valve replacement remains the 'gold standard' in comparison to transcatheter aor c valve implanta on (TAVI)

Biography:

Hatem Al-Masri is a cardiac cri cal care Intensivist and Consultant of cardiac surgery. Dr. Al-Masri completed his medical degree (M.D.-Doktorate) at Charles University Faculty of Medicine, holds a degree in biochemistry from the University of Waterloo, Canada, completed his residency training in Germany (Leading Facharzt) and holds training fellowships in Cardiac Surgery from IJN KL Malaysia, Switzerland, and Canada. Dr. Al-Masri is the author of an award-wining medical research paper  tled “Hemodynamic Support Requires Integrated Approach Comparing LVAD vs. IABP in Pa ents Experiencing Le  Ven cular Failure” (Best Paper of Young Cardiac Surgeon) at the 8th Interna onal Congress of Update in Cardiology and Cardiovascular Surgery (UCCVS 2012) awarded by European Society for Cardiovascular Surgery, World Society of Arrhythmias (WSA ) and the Society of Cardiology and the Interna onal Academic of Vascular and Endovascular Surgery (ISCP).  Dr. Al-Masri is a member of the Medical German Associa on, Malaysian Medical Associa on and the Saudi Medical Council, in addi on to, Saudi Medical council. 

Abstract

Background: Surgical AVR is the treatment of choice for pa ents with symptoma c severe degenera ve aor c stenosis, as it off ers both symptoma c relief and the poten al for improved long-term survival.  An increasing number of elderly pa ents with mul ple comorbidi es are referred for transcatheter aor c valve implanta on (TAVI), partly due to the perceived high risks of surgery. These include in par cular pa ents who have had previous cardiac surgery. The study aim was to compare the outcomes of pa ents with aor c valve disease.  Methods: All pa ents aged > 76 years that underwent a procedure for severe aor c stenosis with or without coronary revasculariza on at the authors' ins tu on were included in the study; thus, 308 pa ents underwent previous cardiac surgery was allocated to TAVI TAVI and 192 underwent previous surgery and subsequently had redo surgery AVR. Pa ents in the TAVI group were older (mean age 87). Treatment modali es were chosen for individual pa ents according to their EuroSCORE and had a higher 
logis c EuroSCORE.  Results: A total of 500 pa ents was discussed ,of these pa ents, 192 underwent TAVI, 308 of whom had undergone previous cardiac surgery Twenty one pa ents (10%) died during the procedure in the TAVI group, and 32 (13%) died in the AVR group . Predictors for mortality were: age, female gender and surgical valve replacement .Gradients across the implanted valves at one to three months postopera vely were lower in the TAVI group  .  Conclusion: Surgical aor c valve replacement remains the 'gold standard' treatment for aor c valve disease.Improved risk stra fi ca on in pa ents with aor c valve disease and re-do cardiac surgery is required .AVR and TAVI will likely be off ered to diff erent groups of pa ents Transcatheter aor c valve implanta on is the treatment of choice for symptoma c aor c stenosis in the unacceptably high-risk or inoperable pa ents, and is a reasonable op on for highrisk pa ents in general.
 

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