Transcatheter aortic valve implantation for native aortic valve regurgitation:single-centre experience
10.3969/j.issn.1004-8812.2025.01.003
- VernacularTitle:经导管主动脉瓣置入术治疗原发性主动脉瓣反流:单中心治疗经验
- Author:
Xiao-xue ZHANG
1
;
Yi FENG
;
Xian-tao MA
;
Yu-jie YANG
;
Akilu WAJEEHULLAHI
;
Chen-xi YAN
;
Zi-yue ZHANG
;
Zi-jun CHEN
;
Bo QIN
;
Shi-liang LI
;
Cai CHENG
Author Information
1. 华中科技大学同济医学院附属同济医院心脏大血管外科,湖北武汉 430030
- Publication Type:Journal Article
- Keywords:
Transcatheter aortic valve implantation;
Surgical aortic valve replacement;
Native aortic valve regurgitation;
Aortic stenosis
- From:
Chinese Journal of Interventional Cardiology
2025;33(1):33-41
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy and safety of transcatheter aortic valve implantation(TAVI)for the treatment of primary aortic valve regurgitation(NAVR)and to compare the difference in the choice of prosthetic valve size and the difference in complications with aortic stenosis(AS).Methods According to the definition of Valve Academic Research Consortium(VARC-3),143 patients with NAVR/AS treated with TAVI and patients with NAVR treated with surgical aortic valve replacement(SAVR)at Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,China,from March 2019 to September 2024 were selected,and clinical data on baseline,perioperative,and primary endpoint events were were retrospectively collected and compared.Results Forty-three patients with NAVR were treated with TAVI,with a device success rate of 86.0％and a surgical success rate of 95.3％.Subgroup comparisons:(1)NAVR-TAVI group than NAVR-SAVR group:patients in the TAVI group had a significantly shorter operative time than those in the SAVR group(P＜0.001);complete left bundle branch block was more likely to occur after TAVI(P=0.042),and complete right bundle branch block was more likely to occur after SAVR(P=0.044).SAVR postoperatively The incidence of congestive heart failure was higher(P=0.013),and the mortality rate was significantly higher in the SAVR group than in the TAVI group(P=0.019).(2)NAVR-TAVI group than AS-TAVI group:the differences in access selection,THV size[28(22,34)mm vs.24(22,32)mm,P=0.044]and proportion of THV overdiameter[14％(7％,20％)vs.7％(3％,11％),P＜0.001]were statistically significant.patients in AS and NAVR groups had 1 case of permanent pacing after TAVI treatment.In the AS and NAVR groups,there was 1 case of permanent pacemaker implantation after TAVI.2 patients in the AS group were converted to surgical treatment,and 6 patients died.Conclusions The use of"off-label"(transfemoral)and"on-label"(transapical)TAVI devices(both from domestic sources)is safer than SAVR for the treatment of NAVR,especially in elderly and high-risk patients.Compared with patients with AS treated with TAVI,larger diameter annulas are usually selected for NAVR,with higher rates of valve migration,but overall safety and efficacy are comparable to AS.
