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单中心对首批100例患者使用球囊扩张式Myval经导管主动脉瓣系统的经验:30天和1年随访。

Single center experience with the balloon-expandable Myval transcatheter aortic valve system with the first 100 patients: 30-day and 1-year follow-up.

作者信息

Magyari Balázs, Kittka Bálint, Goják Ilona, Kasza Gábor, Schönfeld Kristóf, Szapáry László Botond, Simon Mihály, Kiss Rudolf, Bertalan Andrea, Várady Edit, Gyimesi András, Szokodi István, Horváth Iván

机构信息

Heart Institute, Medical School, University of Pécs, Pécs, Hungary.

Szentágothai Research Centre, University of Pécs, Pécs, Hungary.

出版信息

Catheter Cardiovasc Interv. 2023 Dec;102(7):1317-1330. doi: 10.1002/ccd.30868. Epub 2023 Oct 23.

Abstract

AIMS

To report our single-center data, regarding the first 100 patients who underwent TAVR procedure with the new balloon-expandable MYVAL system. We report 30-day and 1-year outcomes in low to high-risk TAVR patient population.

METHODS

From November 2019 to July 2021, 100 consecutive patients underwent TAVR procedure. Patient outcome was classified according to the VARC-2 definitions. The device performance was assessed using transthoracic echocardiography. Data collection was allowed by the Local Ethical Committee.

RESULTS

The mean age was 74.7 years, 63 (63%) were male. The mean Euroscore II and STS score were 4.8 ± 4.9 and 5.6 ± 3.9, respectively. Transfemoral access was the most frequent (surgical vs. percutaneous 2% vs. 97%) and in one patient surgical subclavian access was used. VARC-2 outcomes were as follows: device success 99%, STROKE 1%, major and minor vascular complication was 1% and 11%, respectively, the rate of new permanent pacemaker implantation was 30.7%. At discharge, the incidence of grade I, grade II aortic regurgitation was 39% and 1%, respectively, without relevant PVL. In-hospital mortality was only 1%. These results included a high proportion (17%) of patients with bicuspid aortic valves. At 1 year, the all-cause mortality rate was 7% (only two due to cardiac event) and only a single patient had valve-related dysfunction requiring surgical aortic replacement.

CONCLUSIONS

TAVR procedure with MYVAL transcatheter heart valve system shows excellent 30-day and 1-year outcomes regarding patient survival, technical success, and valve-related adverse events. The limitations of our study comprise a single-center study with retrospective data collection.

摘要

目的

报告我们单中心关于首批100例使用新型球囊扩张式MYVAL系统接受经导管主动脉瓣置换术(TAVR)的患者的数据。我们报告了低至高危TAVR患者群体的30天和1年结局。

方法

2019年11月至2021年7月,100例连续患者接受了TAVR手术。患者结局根据VARC-2定义进行分类。使用经胸超声心动图评估器械性能。当地伦理委员会批准了数据收集。

结果

平均年龄为74.7岁,63例(63%)为男性。平均欧洲心脏手术风险评估系统(Euroscore)II和胸外科医师协会(STS)评分分别为4.8±4.9和5.6±3.9。经股动脉入路最为常见(外科手术与经皮穿刺分别为2%与97%),1例患者采用了外科锁骨下动脉入路。VARC-2结局如下:器械成功率为99%,卒中发生率为1%,主要和次要血管并发症发生率分别为1%和11%,新的永久性起搏器植入率为30.7%。出院时,I级、II级主动脉瓣反流发生率分别为39%和1%,无相关瓣周漏。住院死亡率仅为1%。这些结果包括高比例(17%)的二叶式主动脉瓣患者。1年时,全因死亡率为7%(仅2例因心脏事件),仅有1例患者出现瓣膜相关功能障碍需要进行外科主动脉瓣置换。

结论

使用MYVAL经导管心脏瓣膜系统进行的TAVR手术在患者生存、技术成功和瓣膜相关不良事件方面显示出优异的30天和1年结局。我们研究的局限性包括单中心研究及回顾性数据收集。

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