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小主动脉瓣环患者中快速部署主动脉假体的中期结果。

Mid-term outcomes of rapid deployment aortic prostheses in patients with small aortic annulus.

机构信息

Cardiovascular Surgery Service, Virgen de la Arrixaca University Hospital, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain.

Department of Cardiology, Virgen de la Arrixaca University Hospital, University of Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), CIBERCV, Murcia, Spain.

出版信息

Interact Cardiovasc Thorac Surg. 2021 Oct 29;33(5):695-701. doi: 10.1093/icvts/ivab175.

Abstract

OBJECTIVES

The Edwards Intuity valve is a rapid deployment aortic prosthesis that favours less invasive approaches. However, evidence about the clinical behaviour of their smaller sizes is scarce. Herein, we studied haemodynamic behaviours and clinical outcomes of small Intuity prostheses (19-21 mm) in comparison to larger Intuity prostheses (>21 mm).

METHODS

This is an observational study including patients implanted with an Edwards Intuity rapid deployment aortic prosthesis. Patients with prosthesis sizes 19-21 and >21 mm were included. Baseline and perioperative variables, as well as adverse events during the follow-up were recorded and compared between groups.

RESULTS

A total of 122 patients (37% female, mean age 75 ± 4.5 years) were included, of whom 54 (45%) were implanted with a small prosthesis and 68 (55%) with a prosthesis >21 mm. There were no significant differences between patients with small Intuity prostheses and patients with larger prostheses regarding in-hospital mortality (2% vs 4%, P = 0.43) or mortality during the follow-up (3.41 vs 2.45 per 100 patients-years; P = 0.58). Survival in the small Intuity valve group was 95% at 1 year and 83% at 6 years, whereas in the larger Intuity valve group was 96% at 1 year and 78% at 6 years. The presence of a small prosthesis did not influence mid-term survival (log-rank P-value = 0.62).

CONCLUSIONS

This study showed good clinical performance of Intuity aortic prostheses with appropriate mid-term survival in patients with the small aortic annulus. Thus, the Edwards Intuity rapid deployment aortic prosthesis may be considered as a potential option in patients with the small aortic annulus.

摘要

目的

Edwards Intuity 瓣膜是一种快速扩张的主动脉假体,有利于采用微创方法。然而,关于其较小尺寸的临床行为的证据很少。在此,我们研究了与较大的 Intuity 假体(>21mm)相比,较小的 Intuity 假体(19-21mm)的血液动力学行为和临床结果。

方法

这是一项观察性研究,包括植入 Edwards Intuity 快速扩张主动脉假体的患者。纳入了假体尺寸为 19-21 和>21mm 的患者。记录了基线和围手术期变量以及随访期间的不良事件,并对两组进行了比较。

结果

共纳入 122 名患者(37%为女性,平均年龄 75±4.5 岁),其中 54 名(45%)植入了小假体,68 名(55%)植入了>21mm 的假体。在院内死亡率(2%与 4%,P=0.43)或随访期间死亡率(每 100 患者年 3.41 与 2.45;P=0.58)方面,植入小 Intuity 假体的患者与植入较大假体的患者之间无显著差异。小 Intuity 瓣膜组的 1 年生存率为 95%,6 年生存率为 83%,而较大 Intuity 瓣膜组的 1 年生存率为 96%,6 年生存率为 78%。小假体的存在并不影响中期生存率(对数秩检验 P 值=0.62)。

结论

本研究表明,在小主动脉瓣环患者中,Intuity 主动脉假体具有良好的临床性能,中期生存率适当。因此,Edwards Intuity 快速扩张主动脉假体可能是小主动脉瓣环患者的潜在选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8ad/8923414/b49db8df8b13/ivab175f4.jpg

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