Transcatheter-Based Aortic Valve Implantations at Midterm: What Happened to Our Initial Patients? Mirko Doss, MD, Estelle Bianca Buhr, MD, Sven Martens,

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Transcatheter-Based Aortic Valve Implantations at Midterm: What Happened to Our Initial Patients? Mirko Doss, MD, Estelle Bianca Buhr, MD, Sven Martens, MD, Anton Moritz, MD, Andreas Zierer, MD The Annals of Thoracic Surgery Volume 94, Issue 5, Pages 1400-1406 (November 2012) DOI: 10.1016/j.athoracsur.2012.05.051 Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Long-term survival estimates after transapical aortic valve implantation (TAVI) in comparison to calculated life expectancy of the age-matched general German population. The number of at-risk patients who underwent TAVI at 1, 3, and 5 years is indicated. For survivors, estimates were 92% ± 2% at 1 year (81 patients at risk), 90% ± 4% at 3 years (47 patients at risk), and 87% ± 5% at 5 years (16 patients at risk). Kaplan-Meier curves were compared using the log-rank test. The Annals of Thoracic Surgery 2012 94, 1400-1406DOI: (10.1016/j.athoracsur.2012.05.051) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Operative image of a thrombus formation on the leaflets of a transapically implanted aortic valve after the patient discontinued clopidogrel 6 months after valve implantation. Redo operation had to be performed after the patient experienced an increased transvalvular gradient (mean gradient, 50 mm Hg) as confirmed by transesophageal echocardiography and cardiac catheterization. Thrombus formation was seen clinically during the redo operation and confirmed histologically. The valve was replaced with a conventional stented bioprosthesis. The Annals of Thoracic Surgery 2012 94, 1400-1406DOI: (10.1016/j.athoracsur.2012.05.051) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions