Feng Jie, Wei Haixia, Zhang Shiyuan, Li Yao, Liu Hangyu, Wu Yanqing
Department of Cardiology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China.
Department of Cardiology, Shangrao People's Hospital, Shangrao, 334000, Jiangxi Province, China.
Sci Rep. 2025 May 23;15(1):17951. doi: 10.1038/s41598-025-03214-1.
The objective of this study was to evaluate the efficacy of transcatheter aortic valve replacement (TAVR) via the femoral approach in patients with pure aortic regurgitation (AR), with a focus on mortality, adverse event rates, cardiac function, and clinical symptom improvement. The study utilised a single-centre experience to provide insights and offer guidance for the management of TAVR in AR patients. Patients with aortic valve pathology who underwent TAVR at the Second Affiliated Hospital of Nanchang University, from January 2018 to March 2023 were enrolled. They were classified into two groups: pure AR and aortic stenosis (AS) based on preoperative transthoracic echocardiography. We compared baseline characteristics, imaging data, surgical outcomes, and follow-up conditions between them. We focused on the safety and efficacy of TAVR in patients with AR and evaluated these results using regression analysis. The study cohort comprised 87 patients, with 21 in the AR group and 63 in the AS group. We revealed that AR patients exhibited low mortality and adverse event rates following transfemoral TAVR, with notable improvements in postoperative cardiac function and substantial symptom relief. However, the rates of paravalvular leak (PVL), permanent pacemaker (PPM) implantation, and valve-in-valve procedures were relatively elevated. While these findings suggest that TAVR may represent a viable therapeutic option for patients with AR, the elevated rates of PVL, PPM implantation, and readmission underscore the need for further investigation, with larger cohorts and extended follow-up, to more robustly evaluate the long-term safety and efficacy of this approach.
本研究的目的是评估经股动脉途径的经导管主动脉瓣置换术（TAVR）在单纯主动脉瓣反流（AR）患者中的疗效，重点关注死亡率、不良事件发生率、心功能以及临床症状改善情况。该研究利用单中心经验，为AR患者TAVR的管理提供见解并提供指导。纳入了2018年1月至2023年3月在南昌大学第二附属医院接受TAVR的主动脉瓣病变患者。根据术前经胸超声心动图将他们分为两组：单纯AR组和主动脉瓣狭窄（AS）组。我们比较了两组之间的基线特征、影像学数据、手术结果和随访情况。我们重点关注TAVR在AR患者中的安全性和疗效，并使用回归分析评估这些结果。研究队列包括87例患者，其中AR组21例，AS组63例。我们发现，AR患者经股动脉TAVR后死亡率和不良事件发生率较低，术后心功能有显著改善，症状明显缓解。然而，瓣周漏（PVL）、永久起搏器（PPM）植入率和瓣中瓣手术率相对较高。虽然这些发现表明TAVR可能是AR患者的一种可行治疗选择，但PVL、PPM植入率和再入院率较高，这突出表明需要通过更大规模的队列和更长时间的随访进行进一步研究，以更有力地评估该方法的长期安全性和疗效。
