Analysis of differences in complications and risk factors after transcatheter aortic valve replacement between patients with pure aortic regurgitation and stenosis
10.3760/cma.j.cn112149-20240531-00302
- VernacularTitle:单纯主动脉瓣反流和狭窄患者经导管主动脉瓣置换术后并发症的差异及影响因素分析
- Author:
Ruofeng WANG
1
;
Chao ZHANG
;
Chenhui LEI
;
Xuan ZHANG
;
Minhong WANG
;
Juan WANG
;
Yunfeng ZHOU
Author Information
1. 皖南医学院第一附属医院放射科，芜湖 241000
- Publication Type:Journal Article
- Keywords:
Aortic valve stenosis;
Transcatheter aortic valve replacement;
Pure aortic regurgitation;
Postoperative complications
- From:
Chinese Journal of Radiology
2025;59(4):432-440
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the differences in complications after transcatheter aortic valve replacement (TAVR) between patients with pure aortic regurgitation (PAR) and aortic valve stenosis (AS), and to explore the risk factors for the occurrence of major complications.Methods:Totally 124 patients who underwent TAVR at the First Affiliated Hospital of Wannan Medical College between October 2021 and January 2024 were retrospectively included. Patients were divided into the PAR group (64 cases) and AS group (60 cases) based on preoperative echocardiography findings. Preoperative clinical data, echocardiography, CT imaging data,and postoperative complications were collected. The differences between the two groups in postoperative complications and preoperative clinical data, imaging data were compared. Multivariate logistic regression analysis was used to assess the risk factors for major complications in the two groups, receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive efficacy of major risk factors for common postoperative complications in both groups.Results:The major complication in the PAR group was conduction disturbance (CD, 33 cases); the major complication in the AS group was perivalvular leakage (PVL, 41 cases). Comparison of preoperative data showed that in the PAR group, there were statistically significant differences in the shortest diameter of the membranous septum (MS) and the ratio of the shortest to longest MS diameter between patients with and without postoperative CD (both P<0.05). In the AS group, there were statistically significant differences in the long diameter of the aortic annulus, annular area, annular perimeter, and calcification score of the anchoring zone between patients with and without postoperative PVL (all P<0.05). Multivariate logistic regression analysis revealed that the shortest diameter of the MS was an independent risk factor for postoperative CD in PAR patients ( OR=0.628,95% CI 0.437-0.902, P=0.012), and the area under the ROC curve was 0.751 (95% CI 0.630-0.872, P=0.001). Meanwhile, the calcification score of the anchoring zone was an independent risk factor for postoperative PVL in AS patients ( OR=1.454,95% CI 1.055-2.003, P=0.022), and the area under the ROC curve was 0.740 (95% CI 0.601-0.879, P=0.003). Conclusions:After TAVR, complications differ between PAR and AS patients. CD is the major complication in PAR patients, with the shortest diameter of the MS being a risk factor. Conversely, PVL is the major complication in AS patients, with the calcification score of the anchoring zone identified as a risk factor.
