Liao Yan-Biao, Zhao Zhen-Gang, Wei Xin, Xu Yuan-Ning, Zuo Zhi-Liang, Li Yi-Jian, Zheng Ming-Xia, Feng Yuan, Chen Mao
Department of Cardiology, West China Hospital, Sichuan University, People's Republic of China.
Catheter Cardiovasc Interv. 2017 Mar;89(S1):528-533. doi: 10.1002/ccd.26912.
Transcatheter aortic valve implantation (TAVI) has been demonstrated to be an effective alternative to surgical aortic valve replacement (SAVR) in patients with aortic stenosis who are deemed high risk or inoperable. Currently, TAVI procedures in China mostly make use of the domestic Venus A-Valve and the CoreValve; however, there is no data on their comparative performance.
Consecutive patients undergoing TAVI with the aforementioned devices were included. The outcomes were reported according to the Valve Academic Research Consortium-2 (VARC) definitions.
A total of 54 TAVI procedures were performed, 27 with the CoreValve and the other 27 with the Venus A-Valve. An additional valve was required in 4 (14.8%) and 3 (11.1%) patients, and the VARC-2 device success rates were 81.5 and 85.2%, respectively. The incidences of common complications were similar, except for the significantly less frequent pacemaker insertion in the Venus A-Valve group (7.4 vs. 37.0%, P = 0.03). Within 30 days, 2 (3.7%) patients died, 1 in each group, and both had a bicuspid aortic valve (BAV). No other serious complications, such as annular rupture, coronary obstruction and aortic dissection, occurred in the 32 BAV patients treated with the Venus A-Valve (14) or the CoreValve (18). After 2-years of follow-up, there was no significant difference between CoreValve group and Venus-A group (11.1 vs. 7.4%, P = 0.64).
TAVI with the domestic Venus A-Valve is feasible, safe, and can produce favorable short-term outcomes comparable to those with the CoreValve in inoperable or high-risk patients with tricuspid and bicuspid aortic valve stenosis. © 2017 Wiley Periodicals, Inc.
经导管主动脉瓣植入术(TAVI)已被证明是主动脉瓣狭窄患者中高危或无法手术患者进行外科主动脉瓣置换术(SAVR)的有效替代方法。目前,中国的TAVI手术大多使用国产Venus A-Valve和CoreValve;然而,尚无关于它们比较性能的数据。
纳入连续接受上述器械TAVI治疗的患者。根据瓣膜学术研究联盟-2(VARC)定义报告结果。
共进行了54例TAVI手术,27例使用CoreValve,另外27例使用Venus A-Valve。4例(14.8%)和3例(11.1%)患者需要额外植入瓣膜,VARC-2器械成功率分别为81.5%和85.2%。常见并发症的发生率相似,但Venus A-Valve组起搏器植入频率明显较低(7.4%对37.0%,P = 0.03)。30天内,2例(3.7%)患者死亡,每组各1例,且均为二叶式主动脉瓣(BAV)。在接受Venus A-Valve(14例)或CoreValve(18例)治疗的32例BAV患者中,未发生其他严重并发症,如瓣环破裂、冠状动脉阻塞和主动脉夹层。随访2年后,CoreValve组和Venus-A组之间无显著差异(11.1%对7.4%,P = 0.64)。
对于无法手术或高危的三尖瓣和二叶式主动脉瓣狭窄患者,使用国产Venus A-Valve进行TAVI是可行、安全的,并且能产生与CoreValve相当的良好短期结果。© 2017威利期刊公司。