Soong Erica L, Ong Yi Jing, Ho Jamie S Y, Chew Nichola W S, Kong William K F, Yeo Tiong-Cheng, Chai Ping, Tay Edgar L W, Tan Kent, Lim Yinghao, Kuntjoro Ivandito, Sia Ching-Hui
Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Academic Foundation Programme, North Middlesex University Hospital NHS Trust, London, United Kingdom.
AsiaIntervention. 2021 Dec;7(2):103-111. doi: 10.4244/AIJ-D-21-00007.
Although surgical aortic valve replacement (SAVR) is currently the recommended intervention for patients with native AR without aortic stenosis, a significant proportion of Asian patients undergo transcatheter aortic valve replacement (TAVR), which has not been studied fully for safety and outcomes. This systematic review aims to examine the characteristics and outcomes of Asian patients with pure native aortic regurgitation (AR) undergoing TAVR.
PubMed, Embase, Scopus, Web of Science and Cochrane CENTRAL were systematically searched for randomised controlled trials, observational studies and case reports published from inception to 2 April 2020, involving patients of Asian ethnicity with pure native aortic regurgitation who had undergone TAVR. Our primary outcome was all-cause mortality, with secondary outcomes including all major complications. Five studies (n=274 patients) and eight case reports were included. Device success was reported in 94.9% of the patients, the all-cause mortality rate was 4.4%, 2.5% were converted to SAVR, 1.7% had post-operative paravalvular leak and 6.7% required permanent pacemaker implantation.
TAVR has demonstrated acceptable safety and efficacy in Asian patients with pure AR displaying low mortality rates and few adverse outcomes.
尽管目前对于无主动脉狭窄的原发性主动脉瓣反流（AR）患者，外科主动脉瓣置换术（SAVR）是推荐的干预措施，但仍有相当比例的亚洲患者接受经导管主动脉瓣置换术（TAVR），而其安全性和预后尚未得到充分研究。本系统评价旨在研究接受TAVR的亚洲原发性单纯主动脉瓣反流（AR）患者的特征和预后。
系统检索了PubMed、Embase、Scopus、科学引文索引和Cochrane中心对照试验注册库，纳入自数据库建立至2020年4月2日发表的随机对照试验、观察性研究和病例报告，研究对象为接受TAVR的亚洲原发性单纯主动脉瓣反流患者。主要结局为全因死亡率，次要结局包括所有主要并发症。共纳入5项研究（274例患者）和8篇病例报告。报告显示94.9%的患者手术成功，全因死亡率为4.4%，2.5%的患者转为SAVR，1.7%的患者术后出现瓣周漏，6.7%的患者需要植入永久性起搏器。
TAVR在亚洲原发性单纯AR患者中显示出可接受的安全性和有效性，死亡率低，不良结局少。
