Initial Experience With Transcatheter Aortic Valve Implantation in Montenegro


Cardiac Surgery Center, Clinical Center of Montenegro, Podgorica, Montenegro


Background: Transcatheter aortic valve implantation (TAVI) has emerged as an alternative treatment to classic aortic valve replacement (cAVR) for selected, high risk patients with severe aortic stenosis. Objectives: In our study, we compared preoperative parameters and postoperative outcomes in patients with TAVI and classic aortic valve replacement. Patients and Methods: From March 2011 to December 2013, 18 patients received TAVI and 143 patients underwent cAVR. We compared preoperative Euro SCORE, 30 day mortality, complications after six month and echocardiography findings. Results: Patients received TAVI were older than patients underwent cAVR (72.7 ± 2.7: 65.3 ± 2.9; P < 0.001). Euro SCORE was higher in TAVI group (8.0%: 5.6%; P = 0.43). There were no statistically significant differences in 30-day (0.0%: 2.8%; P = 0.932) and 6-month mortality (5.5%: 3.5%; P = 0.822) as well in stroke incidence (11.1%: 2.8%; P = 0.822). Pacemaker implantation is more frequent in TAVI than in cAVR group (22.0%: 2, 1%; P < 0.001). Conclusions: High risk patients needing AVR are optimal candidates for transcatheter aortic valve implantation. TAVI is a valuable solution for high risk patients needing AVR. Obtained results are comparable to results in transthoracic AVR in standard candidates for aortic valve implantation.


  1. 1.Iung B, Baron G, Tornos P, Gohlke-Barwolf C, Butchart EG, Vahanian A. Valvular heart disease in the community: a European experience. Curr Probl Cardiol. 2007;32(11):609–61.

    1. Nkomo VT, Gardin JM, Skelton TN, Gottdiener JS, Scott CG, Enriquez-Sarano M. Burden of valvular heart diseases: a population-based study. Lancet. 2006;368(9540):1005–11.
    2. Nashef SA, Roques F, Michel P, Gauducheau E, Lemeshow S, Salamon R. European system for cardiac operative risk evaluation (EuroSCORE). Eur J Cardiothorac Surg. 1999;16(1):9–13.
    3. Hattler BG, Madia C, Johnson C, Armitage JM, Hardesty RL, Kormos RL, et al. Risk stratification using the Society of Thoracic Surgeons Program. Ann Thorac Surg. 1994;58(5):1348–52.
    4. Vahanian A, Baumgartner H, Bax J, Butchart E, Dion R, Filippatos G, et al. Guidelines on the management of valvular heart disease: The Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology. Eur Heart J. 2007;28(2):230–68.
    5. Vahanian A, Alfieri O, Al-Attar N, Antunes M, Bax J, Cormier B, et al. Transcatheter valve implantation for patients with aortic stenosis: a position statement from the European Association of Cardio-Thoracic Surgery (EACTS) and the European Society of Cardiology (ESC), in collaboration with the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur Heart J. 2008;29(11):1463–70.
    6. Bonow RO, Carabello BA, Chatterjee K, de Leon AC, Jr., Faxon DP, Freed MD, et al. 2008 Focused update incorporated into the ACC/ AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2008;118(15):e523–661.
    7. Andersen HR, Knudsen LL, Hasenkam JM. Transluminal implantation of artificial heart valves. Description of a new expandable aortic valve and initial results with implantation by catheter technique in closed chest pigs. Eur Heart J. 1992;13(5):704–8.
    8. Walther T, Simon P, Dewey T, Wimmer-Greinecker G, Falk V, Kasimir MT, et al. Transapical minimally invasive aortic valve implantation: multicenter experience. Circulation. 2007;116(11 Suppl):I240–5.
    9. Buz S, Pasic M, Unbehaun A, Hetzer R. Transcatheter aortic valve implantation in Jehovah's Witness patients with symptomatic severe aortic valve stenosis. Interact Cardiovasc Thorac Surg. 2012;15(4):766–8.
    10. Cribier A. Development of transcatheter aortic valve implantation (TAVI): a 20-year odyssey. Arch Cardiovasc Dis. 2012;105(3):146–52.
    11. Wilbring M, Tugtekin SM, Alexiou K, Simonis G, Matschke K, Kappert U. Transapical transcatheter aortic valve implantation vs conventional aortic valve replacement in high-risk patients with previous cardiac surgery: a propensity-score analysis. Eur J Cardiothorac Surg. 2013;44(1):42–7. 13. D'Onofrio A, Alfieri OR, Cioni M, Alamanni F, Fusari M, Tarzia V, et al. The impact of transcatheter aortic valve implantation on patients' profiles and outcomes of aortic valve surgery programmes: a multi-institutional appraisal. Interact Cardiovasc Thorac Surg. 2013;16(5):608–11.