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单中心经验:自膨式经导管主动脉瓣系统治疗症状性高危严重主动脉瓣反流患者:一年随访结果。

Single-center experience with self-expanding transcatheter aortic valve system for symptomatic high-risk patients with severe aortic regurgitation: One-year outcomes.

机构信息

Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.

出版信息

Catheter Cardiovasc Interv. 2024 Nov;104(6):1275-1280. doi: 10.1002/ccd.31193. Epub 2024 Aug 27.

Abstract

AIMS

To evaluate the safety and efficacy of transcatheter aortic valve implantation (TAVI) for the treatment of aortic regurgitation (AR).

METHODS

From September 2019 to February 2022, 62 patients who underwent transfemoral TAVI procedure for pure, symptomatic severe AR with the VitaFlow system were enrolled in the current study. The outcomes were assessed according to the Valve Academic Research Consortium 3 criteria. Procedural results and clinical outcomes for 1 year were analyzed.

RESULTS

The mean age was 71.56 ± 7.34 years and 58.1% were male. The mean Society of Thoracic Surgeons score was 5.44 ± 3.22%. The device success rate was 79.0%. Only one patient was converted to open surgery. The in-hospital mortality rate was 1.6%. The 1-year all-cause mortality rate was 6.5%. The new permanent pacemaker implantation rate was 29.0% in-hospital and 30.7% at 1-year follow-up. The second valve implantation rate was 14.5%. No patient developed more than moderate paravalvular leakage during follow-up. The mean ejection fraction improved from 54.05 ± 10.83% at baseline to 59.32 ± 8.70% (p < 0.001 compared with baseline) at 12 months. Left ventricular end-diastolic diameter decreased from 61.62 ± 5.58 mm at baseline to 55.20 ± 4.51 mm (p < 0.001 compared with the baseline) at 12 months.

CONCLUSIONS

Transfemoral TAVI procedure shows efficacy in treating patients with severe pure native AR. The safety is improved with the development of the VitaFlow system.

摘要

目的

评估经导管主动脉瓣置换术(TAVI)治疗主动脉瓣反流(AR)的安全性和疗效。

方法

本研究纳入了 2019 年 9 月至 2022 年 2 月期间 62 例因严重单纯性症状性 AR 而接受经股动脉 VitaFlow 系统 TAVI 治疗的患者。根据 Valve Academic Research Consortium 3 标准评估结局。分析了 1 年的手术结果和临床结局。

结果

患者平均年龄为 71.56±7.34 岁,58.1%为男性。平均胸外科医生协会评分(STS)为 5.44±3.22%。器械成功率为 79.0%。仅 1 例患者转为开放手术。院内死亡率为 1.6%。1 年全因死亡率为 6.5%。住院期间新植入永久起搏器的发生率为 29.0%,1 年随访时为 30.7%。再次瓣膜植入率为 14.5%。随访期间无患者出现中度以上瓣周漏。射血分数从基线时的 54.05±10.83%提高到 12 个月时的 59.32±8.70%(与基线相比,p<0.001)。左心室舒张末期直径从基线时的 61.62±5.58mm 降至 12 个月时的 55.20±4.51mm(与基线相比,p<0.001)。

结论

经股动脉 TAVI 术治疗严重单纯性原发性 AR 患者有效。VitaFlow 系统的发展提高了安全性。

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