医学
反流(循环)
心脏病学
内科学
假肢
狭窄
主动脉瓣置换术
主动脉瓣
外科
临床终点
栓塞
主动脉瓣狭窄
临床试验
作者
Daling Zhu,Yucheng Chen,Yingqiang Guo,Jia Hu,Ji Zhang,Xin Wei,Hong Tang,Yujun Shi
标识
DOI:10.1016/j.ijcard.2015.07.037
摘要
Background To evaluate the safety and efficacy of transcatheter aortic valve implantation (TAVI) for patients with aortic stenosis (AS) or pure/dominant aortic regurgitation (AR) using the J-Valve™ system. Methods Twenty patients with isolated aortic valve disease (11 with pure/dominant AR and 9 with AS) at high risk for open-heart surgery were enrolled in this study. The mean Logistic Euro-SCORE I was 27.2 ± 8.2% (mean age 74.5 ± 4.7 years). Four sizes of prosthesis were used for annular size up to 21 mm (n = 1), 23 mm (n = 2), 25 mm (n = 10) and 27 mm (n = 7). Clinical and echocardiographic evaluations were performed at baseline, post-procedure and follow-up. The primary endpoint was all-cause mortality. Secondary endpoints were procedural success, major adverse events as well as echocardiographic performance. Results TAVI with the J-Valve™ device was successfully performed in 19 patients (95%). Conversion to surgical valve replacement was necessary in one patient due to prosthesis embolization. No mortality occurred during 90 days follow-up. Pacemaker implantation for new onset conduction disorders was necessary in one patient (5%). For patient with severe AS, post-procedure TAVI resulted in favorable reduction of mean transvalvular gradients (55.3 ± 8.5 vs. 16.4 ± 13.3 mm Hg, P < 0.01). Mean transvalvular gradient was also favorable in AR patients after valve implantation (6.9 ± 1mm Hg). The majority of patients had none or trivial paravalvular regurgitation (17/19) while none had moderate or severe paravalvular regurgitation. Conclusion Trans-apical TAVI using the J-Valve™ prosthesis is potentially an effective treatment option for patients with AS or pure/dominant AR at high risk for open-heart surgery.
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