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《SAPIEN 3 Ultra 球囊扩张式经导管主动脉瓣:S3U 注册研究》:院内和 30 天预后。

In-hospital and thirty-day outcomes of the SAPIEN 3 Ultra balloon-expandable transcatheter aortic valve: the S3U registry.

机构信息

Cardiology unit, Cardio-Thoracic-Vascular Department, University Hospital of Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy.

出版信息

EuroIntervention. 2020 Feb 20;15(14):1240-1247. doi: 10.4244/EIJ-D-19-00541.

Abstract

AIMS

The aim of this study was to evaluate 30-day safety and efficacy outcomes of transcatheter aortic valve implantation (TAVI) performed with the SAPIEN 3 Ultra system.

METHODS AND RESULTS

The S3U registry is a physician-led, post-approval, multicentre, observational registry of transfemoral TAVI with the SAPIEN 3 Ultra. New features include an improved sealing skirt, a 14 Fr expandable sheath and a new delivery catheter. Overall, 139 consecutive patients at nine participating centres were enrolled. Mean age was 81.4±8.3 years, average STS score 3.8±2.4%. The vast majority (97.2%) underwent TAVI with local anaesthesia (28.8%) or conscious sedation (68.3%). Balloon predilatation was performed in 30 patients (21.6%), post-dilatation in three (2.2%). In-hospital, there were no cases of death, stroke, or conversion to open heart surgery. Major vascular complications occurred in three patients (2.2%), as well as major or life-threatening bleedings in three patients (2.2%). There were two moderate (1.4%) and no moderate/severe paravalvular leaks. Median length of stay after TAVI was three days (IQR 3-5 days). At 30 days, there were no deaths, MI, or strokes, and the incidence of new permanent pacemaker implantation was 4.4%.

CONCLUSIONS

This first multicentre international experience of transfemoral TAVI with the SAPIEN 3 Ultra transcatheter heart valve shows good in-hospital and 30-day clinical outcomes.

摘要

目的

本研究旨在评估经导管主动脉瓣置换术(TAVI)中使用 SAPIEN 3 Ultra 系统的 30 天安全性和疗效。

方法和结果

S3U 注册研究是一项由医生主导的、批准后的、多中心、观察性的经股 TAVI 注册研究,使用 SAPIEN 3 Ultra 瓣膜。新特点包括改进的密封裙边、14Fr 可扩张鞘和新的输送导管。共有 9 个参与中心的 139 例连续患者入组。平均年龄为 81.4±8.3 岁,平均 STS 评分 3.8±2.4%。绝大多数(97.2%)患者在局部麻醉(28.8%)或清醒镇静(68.3%)下接受 TAVI。30 例患者(21.6%)进行了球囊预扩张,3 例(2.2%)进行了后扩张。院内无死亡、卒中和转为开胸手术的病例。3 例(2.2%)发生大血管并发症,3 例(2.2%)发生大或危及生命的出血。2 例中度(1.4%)和无中度/重度瓣周漏。TAVI 后中位住院时间为 3 天(IQR 3-5 天)。30 天时,无死亡、心梗或卒中等事件,新植入永久起搏器的发生率为 4.4%。

结论

这是首例使用 SAPIEN 3 Ultra 经导管心脏瓣膜行经股 TAVI 的多中心国际经验,显示出良好的院内和 30 天临床结果。

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