Early outcomes of transapical transcatheter aortic valve implantation versus surgical aortic valve replacement in patients with severe aortic stenosis: A retrospective cohort study in a single center
- VernacularTitle:经心尖经导管主动脉瓣植入术与外科主动脉瓣置换术治疗重度主动脉瓣狭窄早期临床疗效的单中心回顾性队列研究
- Author:
Yu'ang HUANG
1
;
Zhiwei ZHAO
1
;
Xiang KONG
1
Author Information
1. Department of Cardiovascular Surgery, The First Affiliated Hospital of University of Science and Technology of China, Hefei, 230001, P. R. China
- Publication Type:Journal Article
- Keywords:
Severe aortic stenosis;
transcatheter aortic valve implantation;
transapical approach;
surgical aortic valve replacement
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2025;32(12):1722-1727
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the early clinical efficacy and safety of transapical transcatheter aortic valve implantation (TA-TAVI) with surgical aortic valve replacement (SAVR) in patients with severe aortic stenosis (AS). Methods A retrospective study was conducted on patients with severe AS admitted to the Department of Cardiovascular Surgery, The First Affiliated Hospital of University of Science and Technology of China from January 2020 to March 2024. According to the surgical method, patients were divided into a SAVR group and a TA-TAVI group, and the clinical data of the two groups were compared. Results A total of 71 patients were included, with 45 in the SAVR group, including 33 males and 12 females, aged 16-75 (60.89±10.88) years; 26 in the TA-TAVI group, including 15 males and 11 females, aged 61-83 (72.85±5.53) years. The results showed that postoperative aortic valve transvalvular flow velocity [(2.31±0.38) m/s vs. (2.60±0.50) m/s, P=0.019] and transvalvular pressure gradient [(21.09±6.03) mm Hg vs. (28.20±10.79) mm Hg, P=0.001] in the TA-TAVI group were lower than those in the SAVR group. In terms of left ventricular end-diastolic diameter, both preoperative [(56.73±7.74) mm vs. (52.36±7.00) mm, P=0.017] and postoperative [(52.61±7.18) mm vs. (48.04±4.78) mm, P=0.010] values in the TA-TAVI group were larger than those in the SAVR group. In terms of left ventricular ejection fraction, the preoperative value in the TA-TAVI group was lower than that in the SAVR group (58.00%±13.84% vs. 64.87%±7.63%, P=0.026), but there was no statistical difference between the two groups after surgery (P=0.670). The operation time and drainage volume on the first day after surgery in the TA-TAVI group were shorter or lower than those in the SAVR group (P<0.05). There was no statistical difference between the two groups in the postoperative hospital stay, ICU stay, or postoperative mechanical ventilation time (P>0.05). In addition, no serious complications occurred in patients after SAVR, while perivalvular leakage (2 patients), third-degree atrioventricular block (1 patient), and death (3 patients) occurred in the TA-TAVI group. Conclusion For elderly patients with severe AS and poor cardiac function, TA-TAVI technology has minimal surgical trauma, high safety and effectiveness, and is a safe and effective treatment option besides traditional surgical operations.
