Characteristics and outcomes following transcatheter aortic valve replacement in China: a report from China aortic valve transcatheter replacement registry (CARRY).
10.1097/CM9.0000000000001882
- VernacularTitle:Characteristics and outcomes following transcatheter aortic valve replacement in China: a report from China aortic valve transcatheter replacement registry (CARRY)
- Author:
Yi-Ming LI
1
;
Tian-Yuan XIONG
1
;
Kai XU
2
;
Zhen-Fei FANG
3
;
Lei JIANG
4
;
Jun JIN
5
;
Sheng-Hu HE
6
;
Yi-Ning YANG
7
;
Jing-Jing HE
1
;
Yu-Heng JIA
1
;
Yi ZHANG
1
;
Yong PENG
1
;
Yuan FENG
1
;
Mao CHEN
1
Author Information
1. Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
2. Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, Liaoning 110000, China.
3. Department of Cardiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410013, China.
4. Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, China.
5. Department of Cardiology, Xinqiao Hospital of Third Military Medical University, Chongqing 400037, China.
6. Department of Cardiology, Subei People's Hospital, Yangzhou, Jiangsu 225001, China.
7. Department of Cardiology, The First Affiliated Hospital of Xinjiang Medical University, Wulumuqi, Xinjiang 830011, China.
- Publication Type:Observational Study
- MeSH:
Aged;
Aged, 80 and over;
Aortic Valve/surgery*;
Aortic Valve Stenosis/surgery*;
Humans;
Male;
Registries;
Retrospective Studies;
Risk Factors;
Transcatheter Aortic Valve Replacement/adverse effects*;
Treatment Outcome
- From:
Chinese Medical Journal
2021;134(22):2678-2684
- CountryChina
- Language:English
-
Abstract:
BACKGROUND:The past decade has witnessed an ever-increasing momentum of transcatheter aortic valve replacement (TAVR) and a subsequent paradigm shift in the contemporary management of severe aortic stenosis (AS). We conducted a multi-centric TAVR registry based on Chinese patients (the China Aortic valve tRanscatheter Replacement registrY [CARRY]) to delineate the clinical characteristics and outcomes of Chinese patients who underwent TAVR and compare the results between different valve types in different Chinese regions.
METHODS:CARRY is an all-comer registry of aortic valve disease patients undergoing TAVR across China and was designed as an observational study that retrospectively included all TAVR patients at each participating site. Seven hospitals in China participated in the CARRY, and 1204 patients from April 2012 to November 2020 were included. Categorical variables were compared using the chi-squared test, and continuous variables were analyzed using a t test or analysis of variance (ANOVA) test. The Kaplan-Meier curve was used to estimate the risk of adverse events during follow-up.
RESULTS:The mean age of the patients was 73.8 ± 6.5 years and 57.2% were male. The median Society of Thoracic Surgeon-Predicted Risk of Mortality score was 6.0 (3.7-8.9). Regarding the aortic valve, the proportion of bicuspid aortic valve (BAV) was 48.5%. During the hospital stay, the stroke rate was 0.7%, and the incidence of high-degree atrioventricular block indicating permanent pacemaker implantation was 11.0%. The in-hospital all-cause mortality rate was 2.2%. After 1 year, the overall mortality rate was 4.5%. Compared to patients with tricuspid aortic valve (TAV), those with BAV had similar in-hospital complication rates, but a lower incidence of in-hospital mortality (1.4% vs. 3.3%) and 1 year mortality (2.3% vs. 5.8%).
CONCLUSIONS:TAVR candidates in China were younger, higher proportion of BAV, and had lower rates of post-procedural complications and mortality than other international all-comer registries. Given the use of early generation valves in the majority of the population, patients with BAV had similar rates of complications, but lower mortality than those with TAV. These findings further propel the extension of TAVR in low-risk patients.
TRIAL REGISTRATION:https://www.chictr.org.cn/ (No. ChiCTR2000038526).
