Transcatheter aortic valve replacement for elderly patients with severe aortic valve stenosis and bicuspid aortic valve
10.3760/cma.j.cn112434-20241031-00269
- VernacularTitle:经导管主动脉瓣置换治疗老年主动脉瓣重度狭窄
- Author:
Xiaoting LI
1
;
Lulu LIU
;
Jun SHI
;
Yuqiang WANG
;
Zechao RAN
;
Yingqiang GUO
Author Information
1. 四川大学华西医院 心脏大血管外科，成都 610045
- Publication Type:Journal Article
- Keywords:
Evolut Pro;
Transcatheter aortic valve replacement;
Aortic stenosis;
Self-expanding transcatheter aortic valve
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2025;41(8):460-466
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the safety and efficacy of transcatheter aortic valve replacement (TAVR) with self-expandable bioprosthetic valves (Evolut PRO, Medtronic Inc.) in elderly patients with aortic stenosis.Methods:This single-center, single-arm, retrospective cohort study included all consecutive patients who underwent TAVR using Evolut PRO at West China Hospital of Sichuan University between May 2022 and July 2024, and collected all their data at baseline, postoperative, and 30 days. The primary endpoint was all-cause mortality, and secondary endpoints included cardiac mortality, stroke, permanent pacemaker implantation(PPI), bleeding events, vascular and peripheral access complications, acute kidney injury, and hemodynamic data.Results:70 patients were included in the study, including 25 of (35.7%) tricuspid aortic valve (TAV), 23 (32.9%) of Type 0 bicuspid aortic valve (BAV) 20 (28.6%) of Type 1 BAV, and 2 (2.9%) of Type 2 BAV. The mean age was (72.9±6.6) years, 37 (52.9%) were male, and 70 (100%) had a New York Heart Association (NYHA) grade Ⅲ or Ⅳ. Sixty-nine (98.6%) achieved successful surgery, and 1 patient (1.4%) was converted intraoperatively to open-chest surgery. At 30 days, all-cause and cardiovascular mortality were 0, the incidence of stroke was 0, the rate of PPI was 8.7%, and no moderate or greater paravalvular leaks were observed. All patients improved to Class Ⅰ or Ⅱ after receiving TAVR. The mean aortic valve gradient (AVG) decreased from (54.1 ± 18.0 )mmHg(1mmHg=0.133kPa) at baseline to (10.5 ± 5.2)mmHg at 30 days. There were no significant differences in the results among the Type 0 BAV, Type 1/2 BAV, and TAV groups.Conclusion:Evolut PRO is safe and effective in early clinical treatment of elderly patients with aortic valve stenosis.
