5年随访期间Trifecta生物人工瓣膜结构性瓣膜退化和失效的比率和预测因素:单中心经验。

IF 0.7 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Journal of Cardiovascular Echography Pub Date : 2024-01-01 Epub Date: 2024-04-26 DOI:10.4103/jcecho.jcecho_74_23
Anas Mohamad Hashem, Ahmed Elkhapery, Amr Mohamed, Rupinder Buttar, Amani Khalouf, Mohamed Salah Mohamed, Faiz Abbas, Saif Ur Rehman, Mahmoud Eisa, Bipul Baibhav, Devesh Rai, Jeremiah P Depta
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引用次数: 0

摘要

简介Trifecta 生物人工瓣膜已被普遍用于外科主动脉瓣置换术(SAVR)。已有多项研究确定了结构性瓣膜退化(SVD)和失败(SVF)的发生率,但结果仍存在争议。因此,我们旨在开展这项单中心研究,以估计 SVD/SVF 的发生率和预测因素:这项回顾性观察队列单中心研究于 2014 年至 2019 年期间在 Trifecta SAVR 患者中进行。数据来源于基线和随访(3-5 年)时的电子病历。统计分析的显著性水平为P≤0.05:结果:共确定了 271 名符合条件的患者。大部分样本为男性(57.9%),平均年龄为(71.1 ± 10.6)岁。术前平均射血分数(EF)为 53.0%,术后EF(53.6%)无变化(P = 0.88)。最近的随访射血分数显示射血分数显著增加(55.2%),P = 0.01。此外,从峰值速度到 PVMRE 有明显增加(平均差 [MD] ± 平均标准误 (SEM) [0.15±0.04],P < 0.01),从压力梯度 (PGIPE) 到 PGMRE 有增加(MD ± SEM [1.70±0.49],P < 0.01),从多普勒速度指数 (DVIIPE) 到 DVIMRE 有减少(MD ± SEM [-0.037±0.01],P = 0.01)。在 SVF 率方面,13 例(4.8%)患者在整个研究期间出现瓣膜故障,需要更换瓣膜:结论:在为期 5 年的随访中,4.8% 的患者出现 SVF,SVD 为 23.2%,除 6 名患者外,大多数 SVD 无临床意义。这些结果与之前发表的一项研究结果相吻合,该研究结果表明,Trifecta 瓣膜置入术的临床效果不佳。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Rates and Predictors of Structural Valve Degeneration and Failure of Trifecta Bioprosthetic Valve Over a 5-year Follow-up Period: A Single-center Experience.

Introduction: The Trifecta bioprosthetic valve has been commonly used for surgical aortic valve replacement (SAVR). Multiple studies have been done to define the rate of structural valve degeneration (SVD) and failure (SVF), but the outcomes are still debatable. Therefore, we aim to conduct this single-center study to estimate the rate and predictors of SVD/SVF.

Methodology: This retrospective observational cohort single-center study was conducted between 2014 and 2019 among Trifecta SAVR patients. Data were patient's characteristics collected from electronic medical records at baseline and follow-up (3-5 years). Statistical analysis was performed with a significance level of P ≤ 0.05.

Results: A total of 271 eligible patients were identified. Most of our sample were males (57.9%), with a mean age of 71.1 ± 10.6 years. The mean baseline preoperative ejection fraction (EF) was 53.0%, with no change (P = 0.88) in the immediate postoperative EF (53.6%). A most recent follow-up EF revealed a significant increase of EF (55.2%), P = 0.01. Furthermore, there was a significant increase from peak velocity to PVMRE (mean difference [MD] ± standard error of mean (SEM) [0.15 ± 0.04], P < 0.01), an increase in pressure gradient (PGIPE) to PGMRE (MD ± SEM [1.70 ± 0.49], P < 0.01), and a decrease in Doppler velocity index (DVIIPE) to DVIMRE (MD ± SEM [-0.037 ± 0.01], P = 0.01). Regarding the SVF rate, 13 (4.8%) patients had failed valves requiring replacement throughout the study period.

Conclusions: Over a 5-year follow-up period, 4.8% had SVF with an SVD of 23.2%, with the majority of SVD not being clinically significant except in six patients. These results corroborate with a previously published study suggesting a bad clinical outcome of Trifecta valve placement.

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来源期刊
Journal of Cardiovascular Echography
Journal of Cardiovascular Echography CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
1.40
自引率
12.50%
发文量
27
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