152: Transcatheter aortic valve implantation in patients with Hodgkin's lymphoma

Abstract

Transcatheter aortic valve implantation (TAVI) has emerged as a valuable alternative to surgical aortic valve replacement with promising results for patients with severe aortic stenosis (AS) considered as being at high or prohibitive surgical risk. Results in the high-risk subgroup of patients with post-radiation AS was unknown. From October 2006 to June 2011, among the 272 patients who underwent a TAVI at our institution, 12 had post-radiation AS due to Hodgkin's lymphoma and 260 had degenerative AS. Complications were assessed according to VARC definitions. Post-radiation AS patients were younger (61±11 vs. 83±7 years, p<0.0001), had a lower Euroscore were (9±9% vs. 25±13%, p=0.0003) but presented more frequently with porcelain aorta (60% vs. 13%, p<0.0001). TAVI results and complications are presented in the Table. In the post-radiation AS, mortality rate was not significantly different (one death due to a severe sepsis) but there was less complications especially a lower rate of major vascular complications, hospital duration was shorter and patients more frequently discharged at home. Among AS patients who underwent a TAVI, post-radiation patients experienced a lower rate of complications than patients with degenerative AS. In regard to the high mortality and morbidity of conventional surgery, our results suggest that TAVI may be an elective indication for post-radiation AS patients but deserve further confirmation in larger series.