Prosthesis-patient mismatch in high-risk patients with severe aortic stenosis: A randomized trial of a self-expanding prosthesis
Prosthesis-patient mismatch in high-risk patients with severe aortic stenosis: A randomized trial of a self-expanding prosthesis
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DOI：
10.1016/j.jtcvs.2015.10.070
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发表时间：
2016-04-01
影响因子：
6
通讯作者：
Reardon, Michael J.
中科院分区：
文献类型：
--
作者：
Zorn, George L., III;Little, Stephen H.;Reardon, Michael J.
目的：在CoreValve美国高风险关键试验中，我们比较了使用自膨胀生物假体的经导管主动脉瓣置换术（TAVR）和手术主动脉瓣置换术（SAVR）的假体-患者不匹配（PPM）的发生率。我们试图确定PPM对临床结果的影响。方法：严重主动脉瓣狭窄且手术风险增加的患者按1:1随机分为TAVR或SAVR。术后PPM由有效孔面积指数（EOAi）定义为严重PPM (EOAi 0.65 cm(2)/m(2))；对TAVR组（n = 389）和SAVR组（n = 353）的临床结果进行分析。在基线和1年时分析左心室质量指数和回归。结果：SAVR组1年时严重PPM的发生率为25.7%，TAVR组为6.2% （P < 0.05）
Objectives: We compared the incidence of prosthesis-patient mismatch (PPM) between transcatheter aortic valve replacement (TAVR) using a self-expanding bioprosthesis and surgical aortic valve replacement (SAVR) in the CoreValve US High Risk Pivotal Trial. We sought to determine the influence of PPM on clinical outcomes.Methods: Patients with severe aortic stenosis and at increased risk for surgery were randomized 1:1 to TAVR or SAVR. Postoperative PPM was defined by the effective orifice area index (EOAi) as severe PPM (EOAi 0.65 cm(2)/m(2)); clinical outcomes were analyzed in the TAVR arm (n = 389) and SAVR arm (n = 353). Left ventricular mass index and regression were analyzed at baseline and 1 year.Results: The incidence of severe PPM in the SAVR group at 1 year was 25.7% versus 6.2% in the TAVR group (P