二叶式主动脉瓣困境：经导管主动脉瓣置入术还是外科主动脉瓣置换术？来自NOTION-2试验的见解。
Bicuspid Aortic Valve dilemma: TAVI or SAVR? Insights from the NOTION-2 trial.
作者信息
Narayan Pradeep
机构信息
Department of Cardiac Surgery, Rabindranath Tagore International Institute of Cardiac Sciences, Narayana Health, 124, EM Bypass, Mukundapur, Kolkata, 700099 India.
出版信息
Indian J Thorac Cardiovasc Surg. 2024 Sep;40(5):645-647. doi: 10.1007/s12055-024-01809-3. Epub 2024 Aug 5.
The Nordic Aortic Valve Intervention-2 (NOTION-2) trial is the first randomized controlled trial to compare transcatheter aortic valve implantation (TAVI) with surgical aortic valve replacement (SAVR) in low-risk patients, specifically focusing on relatively younger patients and those with bicuspid valves. It randomized 370 patients (mean age 71 years) to assess outcomes at 1 year. Results indicated a higher composite primary endpoint rate for TAVI (10.2%) compared to SAVR (7.1%) in the overall cohort, with even more pronounced differences in patients with bicuspid valves (14.3% for TAVI vs. 3.9% for SAVR). The risk of death or disabling stroke at 1 year was also three times higher with TAVI.
北欧主动脉瓣干预-2（NOTION-2）试验是第一项比较经导管主动脉瓣植入术（TAVI）与外科主动脉瓣置换术（SAVR）在低风险患者中的随机对照试验，特别关注相对年轻的患者和二叶式主动脉瓣患者。该试验将370名患者（平均年龄71岁）随机分组，以评估1年时的结果。结果表明，在整个队列中，TAVI组的复合主要终点发生率（10.2%）高于SAVR组（7.1%），在二叶式主动脉瓣患者中差异更为明显（TAVI组为14.3%，SAVR组为3.9%）。TAVI组1年时死亡或致残性中风的风险也高出三倍。
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