Left ventricular mass and valve performance after surgical and transcatheter aortic valve replacement: a single-center experience from Japan.

IF 2.1 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular diagnosis and therapy Pub Date : 2023-10-31 Epub Date: 2023-10-10 DOI:10.21037/cdt-23-119

Yasumi Maze, Toshiya Tokui, Takahiro Narukawa, Masahiko Murakami, Daisuke Yamaguchi, Ryosai Inoue, Koji Hirano, Takeshi Takamura, Kenji Nakamura, Tetsuya Seko, Atsunobu Kasai, Hisato Ito

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引用次数: 0

Abstract

Background: There are few reports on the postoperative left ventricular mass (LVM), aortic valve area (AVA), and pressure gradient (PG) after surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR) in Japan. We aimed to compare the postoperative LVM, AVA, stroke volume (SV), PG, and long-term outcomes between patients undergoing SAVR and TAVR procedures from single center in Japan.

Methods: This was a retrospective cohort study. We included 107 patients who underwent simple SAVR between January 2012 and May 2022 (SAVR group, n=107) and 274 who underwent TAVR between January 2016 and May 2022 (TAVR group, n=274). The overall mean follow-up periods was 28.8±25.9 months (median: 24 months; range, 0.03-117 months).

Results: The aortic valve mean PG (mmHg) was significantly smaller in the TAVR group than in the SAVR group (P<0.001). The AVA index (cm²/m²) was significantly larger in the TAVR group than in the SAVR group (P<0.001). The SV index (mL/m²) was significantly smaller in the SAVR group than in the TAVR group (P=0.02). The LVM index (LVMI) (g/m²) was significantly smaller in the SAVR group than in the TAVR group (P<0.001). The incidence of mild or higher postoperative paravalvular leak (PVL) and pacemaker implantation were significantly higher in the TAVR group. The 5-year postoperative mortality, re-hospitalization, and major adverse cerebral and cardiovascular events (MACCEs) were significantly better in the SAVR group.

Conclusions: The postoperative aortic valve PG, AVA, and SV were better in the TAVR group; however, LVM regression and postoperative outcomes were better in the SAVR group.

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手术和经导管主动脉瓣置换术后的左心室质量和瓣膜性能：来自日本的单中心经验。

背景：在日本，关于外科主动脉瓣置换术（SAVR）和经导管主动脉瓣置换手术（TAVR）后左心室质量（LVM）、主动脉瓣面积（AVA）和压力梯度（PG）的报道很少。我们旨在比较日本单一中心接受SAVR和TAVR手术的患者的术后LVM、AVA、卒中量（SV）、PG和长期结果。方法：这是一项回顾性队列研究。我们纳入了在2012年1月至2022年5月期间接受简单SAVR的107名患者（SAVR组，n=107）和在2016年1月和2022年5月份期间接受TAVR的274名患者（TAVR组，n=274）。总体平均随访期为28.8±25.9个月（中位数：24个月；范围：0.03-117个月）SAVR组明显小于TAVR组（P结论：TAVR组术后主动脉瓣PG、AVA和SV更好；然而，SAVR组LVM消退和术后结果更好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiovascular diagnosis and therapy Medicine-Cardiology and Cardiovascular Medicine

CiteScore

4.90

自引率

4.20%

发文量

期刊介绍： The journal ''Cardiovascular Diagnosis and Therapy'' (Print ISSN: 2223-3652; Online ISSN: 2223-3660) accepts basic and clinical science submissions related to Cardiovascular Medicine and Surgery. The mission of the journal is the rapid exchange of scientific information between clinicians and scientists worldwide. To reach this goal, the journal will focus on novel media, using a web-based, digital format in addition to traditional print-version. This includes on-line submission, review, publication, and distribution. The digital format will also allow submission of extensive supporting visual material, both images and video. The website www.thecdt.org will serve as the central hub and also allow posting of comments and on-line discussion. The web-site of the journal will be linked to a number of international web-sites (e.g. www.dxy.cn), which will significantly expand the distribution of its contents.