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首页> 外文期刊>The American Journal of Cardiology >Long-Term Outcomes for Patients With Severe Symptomatic Aortic Stenosis Treated With Transcatheter Aortic Valve Implantation
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Long-Term Outcomes for Patients With Severe Symptomatic Aortic Stenosis Treated With Transcatheter Aortic Valve Implantation

机译：经导管主动脉瓣植入治疗严重症状性主动脉瓣狭窄的远期结果

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Transcatheter aortic valve implantation (TAVI) is an established technique for the treatment of severe symptomatic aortic stenosis. Data on long-term TAVI outcomes, both hemodynamic and clinical, in real-world practice settings are limited. We aim to explore the long-term clinical results in patients with severe symptomatic aortic stenosis using multiple catheter-based options: 360 TAVI-treated patients were followed up for <= 5 years. The Medtronic CoreValve was used in 71% and the Edwards SAPIEN in 26%. The primary end point was all-cause mortality during follow-up. Outcomes were assessed based on the Valve Academic Research Consortium 2 criteria. The mean +/- SD patient age was 82.1 +/- 6.9 years (56.4% women). The Society of Thoracic Surgeons score was 7.5 +/- 4.7. The clinical efficacy end point and time-related valve safety at 3 years was 50% and 81.7%, respectively. The calculated 3- and 5-year survival rates were 71.6% and 56.4%, respectively. Five-year follow-up data were obtained for 54 patients alive; 96.2% of alive patients were in the New York Heart Association class I and II, 4 years after TAVI. No gender differences in all-cause mortality rates were observed.(p = 0.58). In multivariate, analysis, hospitalization 6 months previous to TAVI (hazard ratio [HR] 1.92, 95% confidence interval [CI] 1.17 to 3.15, p = 0.01), frailty (HR 1.89, 95% CI 1.11 to 3.2, p = 0.02), acute kidney injury (HR 1.93, 95% CI 1.03 to 3.61, p = 0.04), and moderate or more paravalvular aortic regurgitation after TAVI (HR 4.26, 95% CI 2.54 to 7.15, p < 0.001) were independent predictors for all-cause mortality. In conclusion, long-term outcomes of TAVI are encouraging. Prevention and early identification of paravalvular leak and acute renal failure after the procedure would improve short- and long-term outcomes. (C) 2015 Elsevier Inc. All rights reserved.
机译：经导管主动脉瓣植入术（TAVI）是一种用于治疗严重症状性主动脉瓣狭窄的成熟技术。在现实世界中，有关血液动力学和临床的长期TAVI结果的数据有限。我们的目的是使用多种基于导管的方法探讨严重症状性主动脉瓣狭窄患者的长期临床结果：对360例接受TAVI治疗的患者进行了≤5年的随访。 Medtronic CoreValve使用了71％，Edwards SAPIEN使用了26％。主要终点是随访期间的全因死亡率。结果根据Valve学术研究联盟2标准进行评估。 +/- SD患者的平均年龄为82.1 +/- 6.9岁（女性为56.4％）。胸外科医师协会评分为7.5 +/- 4.7。 3年的临床疗效终点和与时间有关的瓣膜安全性分别为50％和81.7％。计算出的3年和5年生存率分别为71.6％和56.4％。获得了54位患者的5年随访数据。 TAVI后4年，有96.2％的活着患者处于纽约心脏协会I级和II级。没有观察到全因死亡率的性别差异（p = 0.58）。在多变量分析中，TAVI前6个月住院（危险比[HR] 1.92，95％置信区间[CI] 1.17至3.15，p = 0.01），体弱（HR 1.89，95％CI 1.11至3.2，p = 0.02） ），急性肾损伤（HR 1.93，95％CI 1.03至3.61，p = 0.04），以及TAVI后中度或更高的主动脉瓣返流（HR 4.26，95％CI 2.54 to 7.15，p <0.001）是所有因素的独立预测因素-造成死亡率。总之，TAVI的长期结果令人鼓舞。手术后预防和及早发现瓣周漏和急性肾衰竭将改善短期和长期预后。 （C）2015 Elsevier Inc.保留所有权利。

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