Department of Cardiology, Swiss Cardiovascular Center Bern, University Hospital, Bern, Switzerland.
Department of Cardiology, Swiss Cardiovascular Center Bern, University Hospital, Bern, Switzerland; Heart Clinic Hirslanden Zurich, Switzerland.
Int J Cardiol. 2019 Sep 1;290:45-51. doi: 10.1016/j.ijcard.2019.03.050. Epub 2019 Mar 28.
Data on long-term outcomes in patients undergoing transcatheter aortic valve implantation (TAVI) is scarce.
We investigated long term outcomes of consecutive patients undergoing TAVI with balloon- and self-expandable bioprostheses (Edwards SAPIEN (ESV), Edwards Lifesciences Inc., Irvine, CA, USA; Medtronic Corevalve system (MCS), Medtronic Inc., Minneapolis, MN, USA).
Among 628 patients (mean age 82.4 ± 5.8 years, 55% female), 489 (77.8%) underwent transfemoral TAVI. 309 (63.2%) patients received a MCS prosthesis, whereas 180 (36.8%) patients were treated with an ESV prosthesis. The median duration of follow-up amounted to 5.2 years (range 3.4-8.3 years). All-cause mortality did not differ between the two groups (MCS 46.9%, ESV 53.4%, CI 95%: RR 1.21 [0.93-1.57], P = 0.15), whereas cardiac mortality was higher in the ESV cohort after 5 years of follow-up (MCS 35.1%, ESV 45.4%, CI 95%: RR 1.37 [1.01-1.86], P = 0.04). Structural valve deterioration, which was on average diagnosed 41.9 months (range 18-60 months) after TAVI, occurred in 8 cases (1.6%), resulting in one repeat intervention.
While half of all patients died within 5 years after TAVI with no significant differences in all-cause mortality, structural valve deterioration was documented in <2% of cases.
经导管主动脉瓣置换术（TAVI）患者的长期预后数据较为缺乏。
我们研究了接受经皮球囊扩张式和自膨式生物瓣（爱德华兹 SAPIEN（ESV），爱德华生命科学公司，欧文，加利福尼亚州，美国；美敦力 CoreValve 系统（MCS），美敦力公司，明尼苏达州明尼阿波利斯）TAVI 的连续患者的长期预后。
在 628 例患者（平均年龄 82.4±5.8 岁，55%为女性）中，489 例（77.8%）接受经股动脉 TAVI。309 例（63.2%）患者植入 MCS 瓣膜，180 例（36.8%）患者植入 ESV 瓣膜。中位随访时间为 5.2 年（范围 3.4-8.3 年）。两组全因死亡率无差异（MCS 组 46.9%，ESV 组 53.4%，95%CI：RR 1.21[0.93-1.57]，P=0.15），但 ESV 组在随访 5 年后心脏死亡率更高（MCS 组 35.1%，ESV 组 45.4%，95%CI：RR 1.37[1.01-1.86]，P=0.04）。结构瓣衰败在 TAVI 后平均 41.9 个月（范围 18-60 个月）诊断，发生 8 例（1.6%），导致 1 例再次介入。
尽管半数患者在 TAVI 后 5 年内死亡，但全因死亡率无显著差异，<2%的患者出现结构瓣衰败。
