Transcatheter mitral valve replacement: long-term outcomes of first-in-man experience with an apically tethered device - a case series from a single centre
Transcatheter mitral valve replacement: long-term outcomes of first-in-man experience with an apically tethered device - a case series from a single centre
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DOI：
10.4244/eij-d-17-00154
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发表时间：
2017-10-01
期刊：
影响因子：
6.2
通讯作者：
Moat, Neil
中科院分区：
文献类型：
--
作者：
Duncan, Alison;Daqa, Anan;Moat, Neil
目的：经导管二尖瓣置换术(TMVR)是治疗二尖瓣返流的一种新技术。方法和结果：5名患者(STS评分14%-23%)在一个中心进行了Tendvne系统的TMVR手术。1例患者(抗凝治疗不力)在TMVR术后9个月脑血管意外死亡。虽然其余患者在TMVR术后出现了公认的并发症(左心室流出道梗阻、瓣膜旁漏、支架血栓)，但所有在TMVR术后18个月/两年存活的患者报告说，与基线相比，NYIIA分级显著降低，运动能力增加。经胸超声心动图显示瓣膜稳定，无跨瓣返流，三尖瓣返流严重程度和肺动脉收缩压显著降低。结论：Tendvne系统在高危手术组应用18个月/2年后，大多数患者存活，患者症状改善，装置稳定，血流动力学良好，无晚期迁移，无新的瓣膜旁渗漏。需要对使用Tendvne系统治疗的患者进行持续跟踪，以便进一步描述其安全性和有效性。
Aims: Transcatheter mitral valve replacement (TMVR) is a novel technique for treating mitral regurgitation. We report 18-month/two-year outcomes of the five first-in-man patients undergoing chronic TMVR with the Tendvne device.Methods and results: Five patients (STS score range 14%-23%) underwent TMVR using the Tendvne system under compassionate use at a single centre. One patient (who was non-compliant with anticoagulation) died nine months after TMVR following a cerebrovascular accident. Whilst sonic of the remaining patients experienced recognised post-TMVR complications (left ventricular outflow tract obstruction, para-valvular leak, stent thrombosis), all patients alive at 18 mouths/two years after TMVR reported significant reduction in NYIIA class and increase in exercise capacity compared to baseline. Transthoracic echocardiography demonstrated valve stability, absent transvalvular mitral regurgitation, and significant reductions in tricuspid regurgitation severity and systolic pulmonary arterial pressure.Conclusions: Eighteen months/two years after compassionate use of the Tendvne system in a high-risk surgical group, the majority of patients were alive, patient symptoms improved, and the device was stable with good haemodynamic function, no late migration and no new paravalvular leak. Continued follow-up of patients treated with the Tendvne system is required in order to describe its safety and efficacy further.