Kerckhoff-Klinik GmbH, Bad Nauheim, Germany.
St.-Johannes-Hospital Dortmund, Dortmund, Germany.
EuroIntervention. 2024 Jan 1;20(1):85-94. doi: 10.4244/EIJ-D-23-00823.
Transcatheter aortic valve implantation is an effective treatment for patients with aortic stenosis; however, complications related to paravalvular leakage (PVL) persist, including increased risk of mortality, cardiovascular mortality, and rehospitalisation.
We sought to evaluate the clinical outcomes and valve performance at 1 year in patients with severe aortic stenosis treated with the ACURATE neo2 valve in a post-market clinical setting.
Valve Academic Research Consortium-2 safety events were assessed up to 1 year. Independent core laboratories evaluated echocardiographic measures of valve performance and hypoattenuated leaflet thickening (HALT; as measured by four-dimensional computed tomography).
The study enrolled 250 patients (64% female; mean age: 81 years; baseline Society of Thoracic Surgeons risk score: 2.9±2.0%); 246 patients were implanted with ACURATE neo2. All-cause mortality was 0.8% at 30 days and 5.1% at 1 year. The 1-year rates for stroke and disabling stroke were 3.0% and 1.3%, respectively. Overall, HALT of >50% leaflet involvement of at least one leaflet was present in 9% of patients at 30 days and in 12% of patients at 1 year. No association was observed between the presence of HALT and 1-year clinical or haemodynamic outcomes. Early haemodynamic improvements were maintained up to 1 year (mean aortic valve gradient: 47.6±14.5 mmHg at baseline, 7.6±3.2 mmHg at 1 year; mean aortic valve area: 0.7±0.2 cm at baseline, 1.7±0.4 cm at 1 year). At 1 year, 99% of patients had mild or no/trace PVL (<1% had moderate PVL; no patient had severe PVL).
The study outcomes confirm favourable performance and safety up to 1 year in patients treated with ACURATE neo2 in routine clinical practice. (ClinicalTrials.gov: NCT04655248).
经导管主动脉瓣植入术是治疗主动脉瓣狭窄患者的有效方法;然而,瓣周漏(PVL)相关并发症仍然存在,包括死亡率增加、心血管死亡率增加和再住院率增加。
我们旨在评估在市场后临床环境中,使用 ACURATE neo2 瓣膜治疗严重主动脉瓣狭窄患者的 1 年临床结局和瓣膜性能。
评估 Valve Academic Research Consortium-2 安全性事件至 1 年。独立核心实验室评估瓣膜性能和低衰减瓣叶增厚(HALT;通过四维计算机断层扫描测量)的超声心动图测量值。
该研究纳入了 250 名患者(64%为女性;平均年龄:81 岁;基线胸外科医师学会风险评分:2.9±2.0%);246 名患者植入了 ACURATE neo2。30 天时全因死亡率为 0.8%,1 年时为 5.1%。1 年时卒中发生率和致残性卒中发生率分别为 3.0%和 1.3%。总体而言,30 天时至少一叶瓣叶受累超过 50%的 HALT 发生率为 9%,1 年时为 12%。HALT 的存在与 1 年临床或血液动力学结局之间没有观察到关联。早期血液动力学改善持续至 1 年(基线平均主动脉瓣梯度:47.6±14.5mmHg,1 年时 7.6±3.2mmHg;基线平均主动脉瓣面积:0.7±0.2cm,1 年时 1.7±0.4cm)。1 年时,99%的患者存在轻度或无/微量 PVL(<1%存在中度 PVL;无患者存在严重 PVL)。
在常规临床实践中,使用 ACURATE neo2 治疗的患者 1 年的结果证实了良好的性能和安全性。(ClinicalTrials.gov:NCT04655248)。