Transcatheter Aortic Valve Replacement in Patients With Pure Native Aortic Regurgitation: Results From a Multicenter Registry Study
10.1097/CD9.0000000000000101
- VernacularTitle:Transcatheter Aortic Valve Replacement in Patients With Pure Native Aortic Regurgitation: Results From a Multicenter Registry Study
- Author:
Xiaofei GAO
1
;
Juan ZHANG
;
Xiangquan KONG
;
Jing CHEN
;
Xiang CHEN
;
Longyan ZHANG
;
Xinyong CAI
;
Jiancheng ZHU
;
Nailiang TIAN
;
Zhen GE
;
Bin WANG
;
Qing ZHOU
;
Xi SU
;
Lang HONG
;
Yan WANG
;
Hong JIANG
;
Junjie ZHANG
;
Shaoliang CHEN
Author Information
1. Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210000, China
- Publication Type:Journal Article
- Keywords:
Aortic valve;
Aortic regurgitation;
Transcatheter aortic valve replacement;
Device success;
Self-expanding valve
- From:
Cardiology Discovery
2024;04(2):134-141
- CountryChina
- Language:English
-
Abstract:
Objective::Patients with untreated severe aortic regurgitation (AR) have a high risk of mortality. Transfemoral transcatheter aortic valve replacement (TF-TAVR) is a treatment option for AR; however, the safety and efficacy of this technique have not been sufficiently established. This study aimed to evaluate the clinical and anatomical variables correlating with device success of TF-TAVR using a self-expanding valve system for pure AR.Methods::Patients with pure native severe AR who underwent TF-TAVR using a self-expanding valve system were registered at 5 Chinese centers. The primary endpoint was device success at 1 month after TAVR. The secondary endpoint was the composite of major adverse cardiovascular events (MACE) at 6 months, including all-cause death, ischemic stroke, emergency conversion to cardiac surgery, and permanent pacemaker implantation. Echocardiography was used to analyze the left ventricular function before the TAVR procedure and during follow-up. Multivariable logistic regression and Cox regression analyses were performed to find relevant independent risk factors.Results::Between September 2019 and February 2022, 79 patients with AR were enrolled in the study. At 1 month, device success was achieved in 60 (75.9%) patients. By 6 months, 29 (36.7%) patients had MACE. Echocardiography revealed improved left ventricular function after TAVR. Multivariate regression analysis demonstrated that the Society of Thoracic Surgeons risk score (odds ratio 0.760, 95% confidence interval (CI): 0.584-0.989; P = 0.041) and annulus perimeter (odds ratio 0.888, 95% CI: 0.796-0.992; P = 0.035) were 2 predictors of device success. Moreover, annulus perimeter (<80.2 mm), but not Society of Thoracic Surgeons risk score, was associated with a significant reduction in MACE at 6 months (hazard ratio 2.223, 95% CI: 1.060-4.659; P = 0.028). Conclusions::TF-TAVR using a self-expanding valve system appears to be a safe and feasible treatment for patients with pure native severe AR, particularly those with a less enlarged annulus.
