Risk factors of vascular complications after transcatheter aortic valve implantation in patients with aortic stenosis
10.3760/cma.j.cn431274-20240131-00221
- VernacularTitle:主动脉瓣狭窄患者经导管主动脉瓣置换术后发生血管并发症的危险因素分析
- Author:
Dongwen MA
1
;
Yi GUI
;
Guoqiang CAI
;
Guoying AN
Author Information
1. 济宁医学院附属医院心脏重症医学科，济宁 272000
- Publication Type:Journal Article
- Keywords:
Aortic valve stenosis;
Transcatheter aortic valve replacement;
Vascular complication
- From:
Journal of Chinese Physician
2025;27(1):86-90
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the risk factors of vascular complications (VC) after transcatheter aortic valve implantation (TAVI) in patients with aortic stenosis.Methods:A total of 80 patients with aortic stenosis admitted to the Affiliated Hospital of Jining Medical University from January 2018 to June 2023 were retrospectively included as the study objects. All patients underwent TAVI surgery and were divided into VC group (13 cases, 16.3%) and N-VC group (67 cases, 83.7%) according to whether VC occurred after TAVI surgery. The preoperative basic characteristics, surgery-related indexes and preoperative laboratory indexes were compared between the two groups. Multivariate logistic regression analysis was used to screen out independent predictors of postoperative VC in patients with aortic stenosis after TAVI. Based on independent predictors, a nomogram model was constructed, and the calibration curve of the nomogram model was drawn for internal verification. Receiver operating characteristic (ROC) curves were drawn to predict VC after TAVI in patients with aortic stenosis, and the predictive efficacy of the combined prediction model was further analyzed.Results:The proportion of female patients, the proportion of diabetic patients, the mean cross-valve pressure difference, the proportion of vascular wall calcification, the proportion of transapical surgical routes, brain natriuretic peptide (BNP) and creatinine in VC group were significantly higher than those in the N-VC group, and the left ventricular ejection fraction was significantly lower than that in the N-VC group, with statistical significance (all P<0.05). Multivariate logistic regression analysis showed that gender, combined diabetes, surgical path and BNP were independent risk factors of postoperative VC in patients with TAVI (all P<0.05). Based on four independent risk factors, a nomogram model was constructed to predict the occurrence of VC after TAVI in patients with aortic stenosis. The calibration curve showed that the predicted value of VC after TAVI in patients with aortic stenosis was in good agreement with the actual observed value ( P>0.05). ROC curve analysis results showed that the area under the curve (AUC) of gender, combined diabetes, surgical path and BNP in predicting the occurrence of VC after TAVI in aortic stenosis patients were 0.745, 0.769, 0.834 and 0.857, respectively, and the AUC of the combined prediction was 0.938. Conclusions:Gender, age, surgical path and BNP are independent predictors of VC after TAVI in patients with aortic stenosis. The nomogram model based on independent predictors has high predictive value.
