Yuntao Lu, Minyan Yin, Ye Yang, Wenshuo Wang, Lili Dong, Xue Yang, Chunsheng Wang, Xiaolin Wang, Jinmiao Chen, Lai Wei
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Patients at potential high risk for CAO were identified retrospectively from 673 consecutive patients who underwent TAVR from January 2015 to July 2021 at Zhongshan Hospital, Fudan University. Procedural results and early outcomes were evaluated according to Valve Academic Research Consortium-3 definitions.</p><p><strong>Results: </strong>A total of 20 consecutive patients (age 72 ± 9 years; 85% female;) were included. The Society of Thoracic Surgeons-Predicted Risk of Mortality was 5% (interquartile range, 4 to 10%). All patients (100%) had at least 2 classical risk factors for CAO by pre-procedural computed tomography analysis, and 90% patients had native aortic valve diseases. TAVR was successful in 95% of cases, with only 1 patient requiring second device implantation. Early safety at 30 days was achieved in all cases without death. All patients were free from CAO, stroke or emergency reintervention. Post-procedural mean aortic valve gradient was 7 (interquartile range, 4, 12) mmHg, and none/trace or mild aortic regurgitation was present in all patients.</p><p><strong>Conclusion: </strong>Stand-alone TAVR using the J-Valve may mitigate the risk of TAVR-induced CAO.</p>","PeriodicalId":48841,"journal":{"name":"Clinical Interventions in Aging","volume":"19 ","pages":"1557-1570"},"PeriodicalIF":3.5000,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439368/pdf/","citationCount":"0","resultStr":"{\"title\":\"A Coronary-Friendly Device Mitigating Risk of Coronary Obstruction in Transcatheter Aortic Valve Replacement.\",\"authors\":\"Yuntao Lu, Minyan Yin, Ye Yang, Wenshuo Wang, Lili Dong, Xue Yang, Chunsheng Wang, Xiaolin Wang, Jinmiao Chen, Lai Wei\",\"doi\":\"10.2147/CIA.S467594\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Transcatheter aortic valve replacement (TAVR) induced coronary artery obstruction (CAO) is a rare but devastating complication. 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引用次数: 0
摘要
目的：经导管主动脉瓣置换术（TAVR）诱发的冠状动脉阻塞（CAO）是一种罕见但具有破坏性的并发症。目前的预防策略需要额外的手术，并可能与不良事件相关。本研究旨在评估在潜在CAO高风险患者中使用J-Valve（金石杰成医疗科技有限公司，中国上海）进行独立TAVR的早期安全性和有效性：CAO定义为需要介入治疗的冠状动脉口阻塞。从复旦大学附属中山医院2015年1月至2021年7月期间连续接受TAVR的673名患者中回顾性地识别出CAO潜在高风险患者。根据瓣膜学术研究联盟-3的定义对手术结果和早期预后进行了评估：结果：共纳入20名连续患者（年龄72±9岁；85%为女性；）。胸外科医师协会预测的死亡率风险为 5%（四分位间范围为 4%至 10%）。根据手术前的计算机断层扫描分析，所有患者（100%）至少有两个典型的 CAO 危险因素，90% 的患者患有原发性主动脉瓣疾病。95%的病例都成功进行了TAVR，只有1名患者需要二次植入设备。所有病例均在 30 天内实现了早期安全，无死亡病例。所有患者均未发生 CAO、中风或紧急再介入。术后平均主动脉瓣梯度为7（四分位间范围为4-12）mmHg，所有患者均无/微量或轻度主动脉瓣反流：结论：使用 J-Valve 进行独立 TAVR 可降低 TAVR 引起 CAO 的风险。
A Coronary-Friendly Device Mitigating Risk of Coronary Obstruction in Transcatheter Aortic Valve Replacement.
Purpose: Transcatheter aortic valve replacement (TAVR) induced coronary artery obstruction (CAO) is a rare but devastating complication. Current preventive strategies need additional procedures and may be associated with adverse events. This study aimed to evaluate the early safety and efficacy of stand-alone TAVR using the J-Valve (Jianshi JieCheng Medical Technology Co. Ltd, Shanghai, China) in patients at potential high risk for CAO.
Patients and methods: CAO was defined as coronary ostia obstruction requiring intervention. Patients at potential high risk for CAO were identified retrospectively from 673 consecutive patients who underwent TAVR from January 2015 to July 2021 at Zhongshan Hospital, Fudan University. Procedural results and early outcomes were evaluated according to Valve Academic Research Consortium-3 definitions.
Results: A total of 20 consecutive patients (age 72 ± 9 years; 85% female;) were included. The Society of Thoracic Surgeons-Predicted Risk of Mortality was 5% (interquartile range, 4 to 10%). All patients (100%) had at least 2 classical risk factors for CAO by pre-procedural computed tomography analysis, and 90% patients had native aortic valve diseases. TAVR was successful in 95% of cases, with only 1 patient requiring second device implantation. Early safety at 30 days was achieved in all cases without death. All patients were free from CAO, stroke or emergency reintervention. Post-procedural mean aortic valve gradient was 7 (interquartile range, 4, 12) mmHg, and none/trace or mild aortic regurgitation was present in all patients.
Conclusion: Stand-alone TAVR using the J-Valve may mitigate the risk of TAVR-induced CAO.
期刊介绍：
Clinical Interventions in Aging, is an online, peer reviewed, open access journal focusing on concise rapid reporting of original research and reviews in aging. Special attention will be given to papers reporting on actual or potential clinical applications leading to improved prevention or treatment of disease or a greater understanding of pathological processes that result from maladaptive changes in the body associated with aging. This journal is directed at a wide array of scientists, engineers, pharmacists, pharmacologists and clinical specialists wishing to maintain an up to date knowledge of this exciting and emerging field.
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