Sawaya Fadi J, Spaziano Marco, Lefèvre Thierry, Roy Andrew, Garot Phillippe, Hovasse Thomas, Neylon Antoinette, Benamer Hakim, Romano Mauro, Unterseeh Thierry, Morice Marie-Claude, Chevalier Bernard
Fadi J Sawaya, Marco Spaziano, Thierry Lefèvre, Andrew Roy, Phillippe Garot, Thomas Hovasse, Antoinette Neylon, Hakim Benamer, Mauro Romano, Thierry Unterseeh, Marie-Claude Morice, Bernard Chevalier, Department of Cardiology, Générale de Santé, Institut Cardiovasculaire Paris-Sud - Hôpital Privé Jacques Cartier, 91300 Massy, France.
World J Cardiol. 2016 Dec 26;8(12):735-745. doi: 10.4330/wjc.v8.i12.735.
To investigate the clinical outcomes of transcatheter aortic valve implantation (TAVI) with the SAPIEN 3 transcatheter heart valve (S3-THV) the SAPIEN XT valve (XT-THV).
We retrospectively analyzed 507 patients that underwent TAVI with the XT-THV and 283 patients that received the S3-THV at our institution between March 2010 and December 2015.
Thirty-day mortality (3.5% 8.7%; OR = 0.44, = 0.21) and 1-year mortality (25.7% 20.1%, = 0.55) were similar in the S3-THV and the XT-THV groups. The rates of both major vascular complication and paravalvular regurgitation (PVR) > 1 were almost 4 times lower in the S3-THV group than the XT-THV group (major vascular complication: 2.8% 9.9%, < 0.0001; PVR > 1: 2.4% 9.7%, < 0.0001). However, the rate of new pacemaker implantation was almost twice as high in the S3-THV group (17.3% 9.8%, = 0.03). In the S3 group, independent predictors of new permanent pacemaker were pre-procedural RBBB (OR = 4.9; = 0.001), pre-procedural PR duration (OR = 1.14, = 0.05) and device lack of coaxiality (OR = 1.13; = 0.05) during deployment.
The S3-THV is associated to lower rates of major vascular complications and PVR but higher rates of new pacemaker compared to the XT-THV. Sub-optimal visualization of the S3-THV in relation to the aortic valvular complex during deployment is a predictor of new permanent pacemaker.
研究使用SAPIEN 3经导管心脏瓣膜（S3-THV）和SAPIEN XT瓣膜（XT-THV）进行经导管主动脉瓣植入术（TAVI）的临床结果。
我们回顾性分析了2010年3月至2015年12月期间在我们机构接受XT-THV TAVI的507例患者和接受S3-THV的283例患者。
S3-THV组和XT-THV组的30天死亡率（3.5%对8.7%；OR = 0.44，P = 0.21）和1年死亡率（25.7%对20.1%，P = 0.55）相似。S3-THV组的主要血管并发症和瓣周反流（PVR）>1的发生率几乎比XT-THV组低4倍（主要血管并发症：2.8%对9.9%，P < 0.0001；PVR>1：2.4%对9.7%，P < 0.0001）。然而，S3-THV组新起搏器植入率几乎是XT-THV组的两倍（17.3%对9.8%，P = 0.03）。在S3组中，新永久起搏器的独立预测因素是术前右束支传导阻滞（OR = 4.9；P = 0.001）、术前PR间期（OR = 1.14，P = 0.05）和植入过程中器械不同轴（OR = 1.13；P = 0.05）。
与XT-THV相比，S3-THV与较低的主要血管并发症和PVR发生率相关，但新起搏器发生率较高。植入过程中S3-THV相对于主动脉瓣复合体的可视化欠佳是新永久起搏器的一个预测因素。
