Aris Amir, Mansouri Asieh, Dehghan Houman, Tabesh Faezeh, Amini Mohammad, Khosravi Farsani Alireza
Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
ARYA Atheroscler. 2025;21(2):18-27. doi: 10.48305/arya.2025.43010.2995.
Valve replacement is an optional treatment for patients with severe aortic stenosis (AS) and is associated with a better prognosis and improved quality of life. However, surgical valve replacement may result in severe complications, especially in the elderly. Transcatheter aortic valve replacement (TAVR) for treating symptomatic aortic stenosis has expanded exponentially, becoming a therapeutic option for intermediate- and high-risk patients. To thoroughly examine and monitor its practices and improve outcomes, our TAVI center in Isfahan established a detailed registry as the primary center for the TAVI procedure.
This prospective study was conducted among all patients who underwent the TAVR procedure from September 2022 to December 2023 in Isfahan. Baseline characteristics (demographic, clinical, and procedural), 30-day outcomes, and one-year mortality data were collected.
A total of 50 patients underwent the TAVI procedure in Isfahan during our registry. Of these, 56% were male, and the mean age was 77.8 ± 6.7 years. The mean calculated STS score was 5.6. Cardiac death occurred in 4 patients (8%), one (2%) experienced a major vascular complication, 5 (10%) required new pacemaker implantation, and acute kidney injury was observed in 14%. Fever/sepsis occurred in 16%, cardiac tamponade in 6%, one patient (2%) had moderate AI, two patients experienced coronary obstructions, and one suffered a major cerebrovascular accident. Additionally, 4 patients (8%) developed atrial fibrillation, 1 (2%) had ventricular tachycardia, and 6 (12%) experienced AV block.
We have shown good both 30-days outcome and one year mortality in our registry that could be a proper option in treating severe AS with comorbidities instead of surgical aortic valve replacement.
瓣膜置换术是重度主动脉瓣狭窄（AS）患者的一种可选治疗方法，与较好的预后和生活质量改善相关。然而，外科瓣膜置换术可能导致严重并发症，尤其是在老年患者中。经导管主动脉瓣置换术（TAVR）用于治疗有症状的主动脉瓣狭窄，其应用呈指数级增长，已成为中高危患者的一种治疗选择。为了全面检查和监测其操作并改善治疗结果，我们在伊斯法罕的经导管主动脉瓣植入术（TAVI）中心建立了一个详细的登记系统，作为TAVI手术的主要中心。
这项前瞻性研究在2022年9月至2023年12月期间在伊斯法罕接受TAVR手术的所有患者中进行。收集了基线特征（人口统计学、临床和手术相关）、30天结局和一年死亡率数据。
在我们的登记期间，伊斯法罕共有50例患者接受了TAVI手术。其中，56%为男性，平均年龄为77.8±6.7岁。计算得出的平均胸外科医师协会（STS）评分为5.6。4例患者（8%）发生心源性死亡，1例（2%）出现严重血管并发症，5例（10%）需要植入新的起搏器，14%观察到急性肾损伤。发热/脓毒症发生率为16%，心包填塞发生率为6%，1例患者（2%）出现中度主动脉瓣反流（AI），2例患者发生冠状动脉阻塞，1例发生重大脑血管意外。此外，4例患者（8%）发生心房颤动，1例（2%）发生室性心动过速，6例（12%）发生房室传导阻滞。
我们的登记研究显示30天结局和一年死亡率均良好，对于合并症的重度AS患者，这可能是替代外科主动脉瓣置换术的合适选择。
