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阿联酋经导管主动脉瓣置换术的结果:来自一个新兴项目的真实世界单中心经验。

Outcomes of Transcatheter Aortic Valve Replacement in the United Arab Emirates: Real-world, Single-centre Experience from an Emerging Programme.

作者信息

Edris Ahmad, Manla Yosef, Al Badarin Firas, Hasan Khwaja, Hashmani Shahrukh, Traina Mahmoud, Khiati Dhiaedin, Khalouf Amani, El Zouhbi Anas, Tuzcu Emin Murat

机构信息

Heart, Vascular and Thoracic Institute, Cleveland Clinic Abu Dhabi Abu Dhabi, United Arab Emirates.

出版信息

Interv Cardiol. 2023 Mar 7;18:e08. doi: 10.15420/icr.2022.04. eCollection 2023.

Abstract

BACKGROUND

Data on outcomes of transcatheter aortic valve replacement (TAVR) in the Middle East, particularly in the United Arab Emirates (UAE), are limited. Whether centres with a low volume of patients requiring the procedure can achieve similar outcomes as those reported in pivotal clinical trials remains unclear. This study evaluates procedural outcomes of patients undergoing TAVR in a newly established programme in the UAE.

METHODS

Procedural outcomes of consecutive patients who underwent transfemoral TAVR at a single centre in the UAE between January 2016 and November 2021 were compared with those at centres in the lowest quartile (Q1) of procedural volume in the Transcatheter Valve Therapy Registry, which covers centres in the US.

RESULTS

Among the 183 patients included in the study, the median age was 76 years (interquartile range [IQR] 71-82), and 42.1% of patients were women, with a median Society of Thoracic Surgeons predicted risk of mortality score of 4.6 (IQR 2.9-7.5). Most of the patients (93.3%) received a balloon-expandable valve. All-cause death within 30 days, stroke and major vascular complications occurred in 0.6%, 0.6% and 2.2% of patients, respectively, compared with 3.1%, 2.2% and 4% in patients treated at Q1 hospitals.

CONCLUSION

Patients undergoing transfemoral TAVR at an emerging centre in the Middle East had favourable outcomes compared with those performed at Q1 hospitals in the US. These findings suggest that careful patient selection for TAVR is critical and may help optimise patient outcomes, especially when procedural volumes are low.

摘要

背景

中东地区,尤其是阿拉伯联合酋长国(阿联酋)经导管主动脉瓣置换术(TAVR)的相关结果数据有限。需要进行该手术的患者数量较少的中心能否取得与关键临床试验报告的结果相似的成果尚不清楚。本研究评估了阿联酋一个新设立项目中接受TAVR治疗的患者的手术结果。

方法

将2016年1月至2021年11月期间在阿联酋一个中心接受经股动脉TAVR的连续患者的手术结果,与经导管瓣膜治疗注册中心手术量处于最低四分位数(Q1)的美国中心的患者手术结果进行比较。

结果

在纳入研究的183例患者中,中位年龄为76岁(四分位间距[IQR]71 - 82),42.1%为女性,胸外科医师协会预测的中位死亡风险评分为4.6(IQR 2.9 - 7.5)。大多数患者(93.3%)接受了球囊扩张瓣膜。30天内全因死亡、中风和主要血管并发症的发生率分别为0.6%、0.6%和2.2%,而在Q1医院接受治疗的患者中这一比例分别为3.1%、2.2%和4%。

结论

与美国Q1医院相比,中东一个新兴中心接受经股动脉TAVR治疗的患者取得了良好的结果。这些发现表明,仔细选择TAVR患者至关重要,这可能有助于优化患者的治疗结果,尤其是在手术量较低时。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/292f/10433106/7993acdb083c/icr-18-e08-g001.jpg

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