经导管主动脉瓣置入术在中国人群二叶式主动脉瓣重度狭窄中的安全性和有效性评估(英文)

Evaluation of the safety and efficacy of transcatheter aortic valve implantation in patients with a severe stenotic bicuspid aortic valve in a Chinese population

目的:评估经导管主动脉瓣置入术在中国人群二叶式主动脉瓣重度狭窄中的安全性和有效性。创新点:首次在中国人群比较经导管主动脉瓣置入术在二叶式和三叶式主动脉瓣重度狭窄中的安全性和有效性。方法:选取2013年3月至2014年9月行经导管主动脉瓣置入术的40位主动脉瓣狭窄的患者,分二叶式和三叶式主动脉瓣两组,比较基线水平、手术以及随访1月结果的差别。结论:经导管主动脉瓣置入术在中国人群中二叶式主动脉瓣重度狭窄中的应用是安全有效的。

Objective： The purpose of this study is to evaluate the safety and efficacy of transcatheter aortic valve implantation （TAVI） in patients with a severe stenotic bicuspid aortic valve （BAV） in a Chinese population. While several groups have reported the feasibility, efficacy, and safety of TAVI for patients with a BAV, worldwide experience of the technique is still limited, especially in China. Methods： From March 2013 to November 2014, high surgical risk or inoperable patients with symptomatic severe aortic stenosis （AS） who had undergone TAVI at our institution were selected for inclusion in our study. Results were compared between a BAV group and a tricuspid aortic valve （TAV） group. Results： Forty patients were included in this study, 15 （37.5%） of whom were identified as having a BAV. In the BAV group, the aortic valve area was smaller （（0.47±0.13） vs. （0.59±0.14） cm2）, the ascending aortic diameter was larger （（40.4±4.4） vs. （36.4±4.3） mm）, and the concomitant aortic regurgitation was lower. No significant differences were found between the groups in the other baseline characteristics. No differences were observed either in the choice of access or valve size. The procedural success achieved in this study was 100%. There were no differences between groups in device success （86.7% vs. 88.0%）, 30-d mortality （6.7% vs. 8.0%）, or 30-d combined end point （13.3% vs. 12.0%）. The incidences of new pacemaker implantation, paravalvular regurgitation and other complications, recovery of left ventricle ejection fraction and heart function were similar in both groups. Conclusions： Patients with a severely stenotic BAV can be treated with TAVI, and their condition after treatment should be similar to that of people with a TAV.