Ten-year Durability, Hemodynamic Performance, and Clinical Outcomes after Transcatheter Aortic Valve Implantation Using a Self-expanding Device.
IF 3
Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
引用次数: 0
Abstract
Introduction: The expansion of transcatheter aortic valve implantation (TAVI) to low-risk and younger patients has increased the relevance of the long-term durability of transcatheter heart valves (THV). The present study aims to assess the 10-year durability, hemodynamic performance, and clinical outcomes after TAVI using the CoreValve system.
Methods: An analysis from a prospective registry with predefined clinical and echocardiographic follow-up included 302 patients who underwent TAVI with the CoreValve system between 2007 and 2015. Bioprosthetic valve failure (BVF) was defined as any bioprosthetic valve dysfunction-related death, re-intervention, or severe hemodynamic valve deterioration.
Results: At the time of TAVI, the mean age was 80.41 ± 7.01 years, and the Society of Thoracic Surgeons (STS) score was 6.13 ± 5.23%. At latest follow-up (median [IQR]: 5 [2-7] years), cumulative all-cause mortality rates at 3, 5, 7, and 10 years was 23.7%, 40%, 65.8%, and 89.8%, respectively. Mean aortic valve area and transvalvular gradient post-TAVI and at 5, 7, and 10 years were 1.94, 1.87, 1.69, and 1.98 cm2 (p = 0.236) and 8.3, 9.0, 8.2, and 10.1 mmHg (p = 0.796), respectively. Overall, 11 patients had BVF, of whom six had structural valve deterioration (SVD). The 10-year actual and actuarial freedom from BVF was 96.1% and 78.8%, and from SVD was 97.9% and 80.9%, respectively. Three patients developed significant non-SVD due to severe paravalvular leakage, and two patients were diagnosed with infective endocarditis.
Conclusion: Using an early-generation self-expanding bioprosthesis, we documented durable hemodynamic performance and low rates of BVF and SVD up to 10 years after TAVI.
使用自扩张装置进行经导管主动脉瓣植入术后的十年耐久性、血流动力学表现和临床结果。
导言：随着经导管主动脉瓣植入术（TAVI）在低风险和年轻患者中的推广，经导管心脏瓣膜（THV）的长期耐久性变得更加重要。本研究旨在评估使用CoreValve系统进行TAVI后的10年耐久性、血液动力学表现和临床结果：方法：通过对预先确定的临床和超声心动图随访的前瞻性登记资料进行分析，纳入了 302 名在 2007 年至 2015 年期间使用 CoreValve 系统进行 TAVI 的患者。生物人工瓣膜功能衰竭（BVF）定义为任何与生物人工瓣膜功能障碍相关的死亡、再次介入或严重血流动力学瓣膜恶化：进行TAVI手术时，患者的平均年龄为（80.41 ± 7.01）岁，胸外科医师协会（STS）评分为（6.13 ± 5.23）%。在最近的随访中（中位数[IQR]：5 [2-7]年），3年、5年、7年和10年的累积全因死亡率分别为23.7%、40%、65.8%和89.8%。TAVI术后及5、7和10年的平均主动脉瓣面积和跨瓣梯度分别为1.94、1.87、1.69和1.98平方厘米（P = 0.236）和8.3、9.0、8.2和10.1毫米汞柱（P = 0.796）。共有 11 名患者出现 BVF，其中 6 名出现结构性瓣膜退化 (SVD)。BVF的10年实际和精算自由度分别为96.1%和78.8%，SVD的10年实际和精算自由度分别为97.9%和80.9%。三名患者因严重的腔瓣旁漏而出现了严重的非SVD，两名患者被诊断为感染性心内膜炎：结论：使用早期一代自膨胀生物前列腺假体，我们记录了TAVI术后10年的持久血流动力学表现以及较低的BVF和SVD发生率。
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来源期刊
Cardiology and Therapy
CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
5.30
自引率
0.00%
发文量
38
审稿时长
6 weeks
期刊介绍：
Aims and Scope
Cardiology and Therapy is an international, open access, peer reviewed (single-blind), rapid-publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of cardiovascular therapies and interventions, including devices. Studies relating to diagnosis and diagnostics, pharmacoeconomics, public health, quality of life, as well as patient care, management and education are also encouraged.
Areas of focus include, but are not limited to, ischaemic heart disease and acute cardiac care, myocardial, valvular, pericardial and congenital heart disease, vascular and pulmonary disease (including hypertension), arrhythmias, heart failure, non-invasive diagnostic techniques, and invasive and interventional cardiology as well as cardiovascular surgery.
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