Long-Term Clinical Outcomes of the Transcatheter Aortic Valve System for Aortic Valve Stenosis.

Zijia Wu, Lulan Gao, Lei Chen, Zhihai Lin
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Abstract

Objective: To evaluate the clinical safety and efficacy of the self-expanding transcatheter aortic valve system in Chinese patients with severe aortic stenosis (AS) during follow-up.

Study design: Observational study. Place and Duration of the Study: Department of Cardiology, Yulin First People's Hospital, The Sixth Affiliated Hospital of Guangxi Medical University, Yulin, Guangxi, China, from April 2020 to September 2022.

Methodology: A retrospective analysis was conducted on 101 patients with severe symptomatic AS who underwent transcatheter aortic valve replacement (TAVR) using a self-expanding transcatheter aortic valve system. Inclusion criteria were patients with severe symptomatic AS at high surgical risk or with contraindications for traditional surgery. Exclusion criteria included active infections and untreated severe coronary artery stenosis. The primary endpoint of this study was the mortality rate or complications within one year after TAVR.

Results: The average age of the cohort was 69.5 ± 7.9 years, with 39.6% (n = 40) being female. The average risk score according to the Society of Thoracic Surgeons was 3.5 ± 2.7%. At one-year follow-up, the all-cause or cardiovascular disease mortality rate was 7.9% (n = 8). Importantly, no reports of major stroke or coronary artery obstruction occurred during the one-year follow-up, and the prognosis of patients with bicuspid aortic valve and tricuspid valve stenosis was comparable.

Conclusion: The studied transcatheter valve replacement system is a safe and effective treatment option for Chinese patients with severe aortic valve stenosis. Future multicentre and larger-scale randomised controlled trials are needed to verify that the self-expanding system can provide long-term benefits.

Key words: Aortic valve stenosis, Transcatheter aortic valve replacement, Self-expanding transcatheter aortic valve system.

经导管主动脉瓣系统治疗主动脉瓣狭窄的长期临床效果。
目的:评价经导管自我扩张主动脉瓣系统在重症主动脉瓣狭窄(AS)患者随访中的临床安全性和有效性。研究设计:观察性研究。研究地点和时间:中国广西玉林市广西医科大学附属第六医院玉林市第一人民医院心内科,2020年4月至2022年9月。方法:回顾性分析101例重度AS患者经导管主动脉瓣置换术(TAVR),采用自扩式经导管主动脉瓣系统。纳入标准为严重症状性AS患者,手术风险高或有传统手术禁忌。排除标准包括活动性感染和未经治疗的严重冠状动脉狭窄。本研究的主要终点是TAVR术后一年内的死亡率或并发症。结果:队列患者平均年龄为69.5±7.9岁,女性占39.6% (n = 40)。胸外科学会的平均风险评分为3.5±2.7%。在1年的随访中,全因或心血管疾病死亡率为7.9% (n = 8)。重要的是,在1年的随访中,没有发生重大中风或冠状动脉阻塞的报告,二尖瓣主动脉瓣和三尖瓣狭窄患者的预后具有可比性。结论:经导管主动脉瓣置换术是我国重度主动脉瓣狭窄患者安全有效的治疗方法。需要未来的多中心和更大规模的随机对照试验来验证这种自我扩展的系统能够提供长期的益处。关键词:主动脉瓣狭窄,经导管主动脉瓣置换术,自扩式经导管主动脉瓣系统
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