二尖瓣
医学
心脏病学
内科学
二尖瓣
狭窄
危险系数
主动脉瓣
冲程(发动机)
阀门更换
主动脉瓣置换术
血流动力学
主动脉瓣狭窄
置信区间
机械工程
工程类
作者
Jingjing He,Tao Xiong,Yijun Yao,Yong Peng,Jiafu Wei,Zhengang Zhao,Guo Chen,Yuanweixiang Ou,Qi Liu,Xi Wang,Zhongkai Zhu,Hao-Ran Yang,Kaiyu Jia,Darren Mylotte,Nicolò Piazza,Bernard Prendergast,Yuan Feng,Mao Chen
出处
期刊:Circulation-cardiovascular Interventions
[Ovid Technologies (Wolters Kluwer)]
日期:2023-12-01
卷期号:16 (12)
被引量:3
标识
DOI:10.1161/circinterventions.123.013083
摘要
BACKGROUND: Data concerning the outcomes of transcatheter aortic valve replacement in type 0 bicuspid aortic stenosis (AS) are scarce. The study aims to compare the outcomes of transcatheter aortic valve replacement for AS in patients with type 0 bicuspid, type 1 bicuspid, and tricuspid aortic valve anatomy. METHODS: We enrolled consecutive patients undergoing transcatheter aortic valve replacement for severe AS between 2012 and 2022 in this single-center retrospective cohort study. The primary outcome was mortality, while secondary outcomes included in-hospital complications such as stroke and pacemaker implantation and transcatheter heart valve hemodynamic performance. RESULTS: The number of patients with AS with type 0 bicuspid, type 1 bicuspid, and tricuspid aortic valve anatomy was 328, 302, and 642, respectively. Self-expanding transcatheter heart valves were used in the majority of patients (n=1160; 91.4%). In the matched population, differences in mortality (30 days: 4.2% versus 1.7% versus 1.7%, P overall =0.522; 1 year: 10% versus 2.3% versus 6.2%, P overall =0.099) and all stroke (30 days: 1.0% versus 0.9% versus 0.0%, P overall =0.765; 1 year: 1.4% versus 1.6% versus 1.3%, P overall =NS) were nonsignificant, and the incidence of overall in-hospital complications was comparable among groups. Ascending aortic diameter was the single predictor of 1-year mortality in type 0 bicuspid patients (hazard ratio, 1.59 [95% CI, 1.03–2.44]; P =0.035). The proportion of patients with a mean residual gradient ≥20 mm Hg was the highest in those with type 0 bicuspid anatomy, although the need for permanent pacemaker implantation was the lowest in this group. CONCLUSIONS: Major clinical outcomes of transcatheter aortic valve replacement for AS in patients with type 0 bicuspid, type 1 bicuspid, and tricuspid aortic valve anatomy are equivalent at short- and mid-term follow-up. These observations merit further exploration in prospective international registries and randomized controlled trials.
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