Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC 20010, USA.
Am Heart J. 2013 May;165(5):710-5. doi: 10.1016/j.ahj.2012.11.015. Epub 2013 Mar 26.
The Edwards SAPIEN transcatheter heart valve (THV) is approved for aortic stenosis patients considered inoperable because of high surgical risk. Based on the high-risk arm of the PARTNER trial, the Food and Drug Administration's Circulatory System Devices Panel reviewed an additional indication for use in high-risk, operable patients. Although several concerns were raised regarding safety, trial misconduct, and several subgroup analyses, most panel members agreed that the Edwards SAPIEN THV (Edwards Lifesciences LLC, Irvine, CA), when used in high-risk patients, is noninferior to surgical aortic valve replacement. The panel voted 11 to 0 (with 1 abstention) that the benefits of the Edwards SAPIEN THV do outweigh the risks for use in the indicated patient population. This summary aims to describe the discussions and recommendations made during the meeting. Based on the panel recommendation, the device was approved by the Food and Drug Administration.
经导管主动脉瓣置换术(TAVR)的爱德华兹 SAPIEN 瓣膜获批用于因手术风险高而被认为不适合手术的主动脉瓣狭窄患者。基于 PARTNER 试验的高危组,美国食品和药物管理局循环系统设备专家组审查了该瓣膜在高危可手术患者中使用的另一个适应证。尽管对安全性、试验不当行为和几个亚组分析提出了一些担忧,但大多数小组成员认为,爱德华兹 SAPIEN 瓣膜(爱德华兹生命科学公司,尔湾,加利福尼亚州)在高危患者中使用时与外科主动脉瓣置换术非劣效。专家组以 11 票对 0 票(1 票弃权)投票决定,在规定的患者人群中使用爱德华兹 SAPIEN 瓣膜的获益大于风险。本总结旨在描述会议期间的讨论和建议。根据专家组的建议,该设备获得了美国食品和药物管理局的批准。