严重主动脉瓣狭窄并发二尖瓣反流患者的 TAVI。

IF 1.8 3区医学 Q2 SURGERY

Journal of Surgical Research Pub Date : 2024-11-12 DOI:10.1016/j.jss.2024.10.012

Mohammed Salem MD , Tomasz Stankowski MD , Sleiman Sebastian Aboul-Hassan MD , Anja Muehle MD , Axel Harnath MD , Kristin Rochor MD , Claude Tshibangu Lukusa MD , Volker Herwig MD , Temirlan Erkenov MD , Barłomiej Perek MD , Dirk Fritzsche MD

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引用次数: 0

摘要

导言：严重主动脉瓣狭窄并发不同程度的二尖瓣反流（MR）是一种常见病。我们的研究旨在评估经导管经股动脉主动脉瓣植入术（TAVI）与并存二尖瓣反流之间的关系，并比较二尖瓣反流改善组和未改善组的疗效：我们回顾性分析了2018年1月至2020年12月期间接受TAVI并伴有至少中度MR的252例患者。比较了出院时和随访 6-12 个月时 MR 分级变化的影响：245名患者在出院时进行了超声心动图检查，154名患者在随访时进行了超声心动图检查。60.8%的患者MR改善，39.2%的患者未改善。MR改善组的总生存率明显更高（P = 0.020）。MR分级对随访的影响具有统计学意义，与出院时相比，轻度MR患者的比例明显增加（58.4%对38.3%，P 结论：MR分级对随访的影响具有统计学意义，与出院时相比，轻度MR患者的比例明显增加（58.4%对38.3%，P）：严重主动脉瓣狭窄合并二尖瓣返流的 TAVI 可降低 60% 以上患者的 MR 严重程度，并改善 LVEF 和死亡率。

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TAVI in Patients With Severe Aortic Stenosis and Coexisting Mitral Valve Regurgitation

Introduction

Severe aortic stenosis with coexisting mitral regurgitation (MR) of various severity is a common finding. The goal of our study was to evaluate the relation between transcatheter transfemoral aortic valve implantation (TAVI) on coexisting MR and compare the outcome in MR improvement and nonimprovement groups.

Methods

We retrospectively analyzed 252 patients who underwent TAVI with associated at least moderate MR between January 2018 and December 2020. Effect of changes in MR grade at discharge and 6-12 mo follow-up were compared.

Results

Echocardiography was performed at discharge in 245 patients and at follow-up in 154 patients. MR improvement was seen in 60.8% patients and nonimprovement in 39.2%. Overall survival was significantly higher in the MR improvement group (P = 0.020). There was a statistically significant effect on MR grade with a significant increase in the proportion of patients with mild MR at follow-up compared to discharge (58.4% versus 38.3%, P < 0.001). A similar positive effect was seen on left ventricular ejection fraction (LVEF) at follow-up compared to discharge (P < 0.001). LVEF in the MR improvement group was significantly higher at follow-up versus discharge (P < 0.001), but there was no statistically significant change in LVEF in the nonimprovement group at follow-up versus discharge (P < 0.722).

Conclusions

TAVI in severe aortic stenosis with coexisting significant mitral valve regurgitation decreases MR severity in more than 60% of patients and improved LVEF as well as mortality.

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来源期刊

Journal of Surgical Research 医学-外科

CiteScore

3.90

自引率

4.50%

发文量

627

审稿时长

138 days

期刊介绍： The Journal of Surgical Research: Clinical and Laboratory Investigation publishes original articles concerned with clinical and laboratory investigations relevant to surgical practice and teaching. The journal emphasizes reports of clinical investigations or fundamental research bearing directly on surgical management that will be of general interest to a broad range of surgeons and surgical researchers. The articles presented need not have been the products of surgeons or of surgical laboratories. The Journal of Surgical Research also features review articles and special articles relating to educational, research, or social issues of interest to the academic surgical community.