Jin Ping, Guo Hong, Mao Yu, Zhai Mengen, Liu Yang, Yang Jian
Department of Cardiovascular Surgery, Xijing Hospital, Air Force Medical University, Xi'an, China.
Front Cardiovasc Med. 2024 Dec 5;11:1424105. doi: 10.3389/fcvm.2024.1424105. eCollection 2024.
Rheumatic mitral stenosis (RMS) is a common valvular heart disease in developing countries. We sought to evaluate the early experience of patients with RMS undergoing transcatheter mitral valve replacement (TMVR).
In this retrospective study, a total of 5 RMS patients accepted TMVR. All patients underwent computed tomography and echocardiography before having the procedure. After the preprocedural comprehensive evaluations, the surgeons planned to use the Prizvalve (a novel balloon-expandable transcatheter aortic valve system which is now under the clinical registration study) for TMVR. Clinical data were collected at baseline, before discharge, and at the 30-day follow-up.
The median age of the 5 RMS patients was 61 years (range 60-77 years); 60% were male, and the median Society of Thoracic Surgeons score was 13.3% (range 6.2-17.1%). TMVR was successful in all patients. Postoperative transesophageal echocardiography showed that 60.0% ( = 3) of the patients had no paravalvular leakage and 40.0% ( = 2) had trace paravalvular leakage. The median postoperative peak velocity decreased to 1.4 m/s (range 1.1-1.7 m/s), and the median pressure gradient decreased to 3 mmHg (range 2-3 mmHg). No deaths occurred at the 30-day follow-up, and all patients had an improvement of ≥1 on the New York Heart Association functional rating.
Our early experience with TMVR in RMS patients suggests that it is a safe and feasible procedure. The early results of the procedure are acceptable and provide bright prospects and directions for the precision treatment of RMS.
ClinicalTrials.gov, identifier (NCT02917980).
风湿性二尖瓣狭窄（RMS）是发展中国家常见的心脏瓣膜病。我们旨在评估接受经导管二尖瓣置换术（TMVR）的RMS患者的早期经验。
在这项回顾性研究中，共有5例RMS患者接受了TMVR。所有患者在手术前均接受了计算机断层扫描和超声心动图检查。在术前综合评估后，外科医生计划使用Prizvalve（一种新型球囊扩张式经导管主动脉瓣系统，目前正在进行临床注册研究）进行TMVR。在基线、出院前和30天随访时收集临床数据。
5例RMS患者的中位年龄为61岁（范围60 - 77岁）；60%为男性，胸外科医师协会评分中位数为13.3%（范围6.2 - 17.1%）。所有患者的TMVR均成功。术后经食管超声心动图显示，60.0%（n = 3）的患者无瓣周漏，40.0%（n = 2）有微量瓣周漏。术后中位峰值速度降至1.4 m/s（范围1.1 - 1.7 m/s），中位压力阶差降至3 mmHg（范围2 - 3 mmHg）。30天随访时无死亡发生，所有患者的纽约心脏协会功能分级均提高了≥1级。
我们在RMS患者中进行TMVR的早期经验表明，该手术是安全可行的。该手术的早期结果是可接受的，为RMS的精准治疗提供了光明的前景和方向。
ClinicalTrials.gov，标识符（NCT02917980）。
