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首页> 外文期刊>Journal of cardiac surgery. >Transapical aortic valve implantation: Experiences and survival analysis up to three years
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Transapical aortic valve implantation: Experiences and survival analysis up to three years

机译：经心尖主动脉瓣植入：长达三年的经验和生存分析

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Background: We determined our 30-day results after transapical aortic valve implantation (TA-AVI) according to Valve Academic Research Consortium criteria, analyzed midterm outcome, and summarize our institutional learning experience. Methods: From February 2008 to July 2011, 150 high-risk patients underwent TA-AVI. Endpoints of this retrospective analysis were safety as indicated by morbidity and 30-day mortality and midterm survival with a follow-up period up to 3.4 years (mean follow-up 14.1 months). In addition we analyzed our institutional learning curve by comparing the outcome of our first 50 patients (group 1) to the following 100 patients (group 2). Results: Procedural success was 98% (147 patients). All-cause and cardiovascular cause 30-day mortality was 11.3% (n = 17) and 7.3% (n = 11), respectively. The cumulative survival rates were 78.7% at one year, 62.8% at two years, and 50.8% at three years. As compared to group 1, there was a significantly reduced incidence of relevant bleeding complications (0% vs. 14%[n = 7]; p < 0.001) and a reduced incidence of acute kidney injury (35%[n = 35] versus 56% (n = 28); p < 0.05) in group 2, resulting in a combined safety endpoint at 30 days of 22% in group 2 versus 40% in group 1 (p < 0.05). One-year mortality (group 2, n = 20 [20%] versus group 1, n = 10 [20%]; p = 1) and midterm survival (p = 0.998; Hazard ratio 1.001; 95% CI 0.5141 to 1.949) did not differ significantly. Conclusions: Although the incidence of technical complications decreased significantly over time, 30-day and midterm mortality were unaltered, most likely due to patients' comorbidities. The development of more accurate risk scores may improve future outcome.
机译：背景：我们根据瓣膜学术研究协会的标准确定了经心尖主动脉瓣植入术（TA-AVI）后的30天结果，分析了中期结局并总结了我们的机构学习经验。方法：自2008年2月至2011年7月，对150位高危患者进行TA-AVI治疗。这项回顾性分析的终点是安全性，如发病率，30天死亡率和中期生存期所指示，随访期最长为3.4年（平均随访14.1个月）。此外，我们通过比较前50名患者（第1组）与随后的100名患者（第2组）的结局来分析我们的机构学习曲线。结果：手术成功率为98％（147例患者）。 30天全因原因和心血管原因死亡率分别为11.3％（n = 17）和7.3％（n = 11）。一年的累积生存率是78.7％，两年是62.8％，三年是50.8％。与第1组相比，相关出血并发症的发生率显着降低（0％比14％[n = 7]; p <0.001），急性肾损伤发生率降低（35％[n = 35]）。第2组中56％（n = 28）; p <0.05），导致30天的组合安全性终点在第2组中为22％，而在第1组中为40％（p <0.05）。一年死亡率（第2组，n = 20 [20％]，第1组，n = 10 [20％]; p = 1）和中期生存率（p = 0.998;危险比1.001; 95％CI 0.5141至1.949）没有显着差异。结论：尽管技术并发症的发生率随时间而显着降低，但30天和中期死亡率并未改变，这很可能是由于患者合并症引起的。制定更准确的风险评分可能会改善未来的结果。

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