Characteristics and outcomes following transcatheter aortic valve replacement in China: a report from China aortic valve transcatheter replacement registry (CARRY).
Characteristics and outcomes following transcatheter aortic valve replacement in China: a report from China aortic valve transcatheter replacement registry (CARRY).
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DOI：
10.1097/cm9.0000000000001882
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发表时间：
2021-11-19
影响因子：
6.1
通讯作者：
Chen M
中科院分区：
文献类型：
--
作者：
Li YM;Xiong TY;Xu K;Fang ZF;Jiang L;Jin J;He SH;Yang YN;He JJ;Jia YH;Zhang Y;Peng Y;Feng Y;Chen M
过去十年见证了经导管主动脉瓣置换术 (TAVR) 的不断增长势头以及随后严重主动脉瓣狭窄 (AS) 当代治疗模式的转变。我们针对中国患者开展了多中心 TAVR 登记（中国主动脉瓣经导管置换登记 [CARRY]），以描述接受 TAVR 的中国患者的临床特征和结果，并比较中国不同地区不同瓣膜类型的结果。 CARRY 是一项针对中国各地接受 TAVR 的主动脉瓣疾病患者的全方位登记，旨在作为一项观察性研究，回顾性地纳入每个参与地点的所有 TAVR 患者。中国有7家医院参与了CARRY，纳入了2012年4月至2020年11月期间的1204名患者。使用卡方检验比较分类变量，并使用 t 检验或方差分析 (ANOVA) 检验分析连续变量。卡普兰-迈耶曲线用于估计随访期间不良事件的风险。患者的平均年龄为73.8±6.5岁，其中57.2%为男性。胸外科医生协会预测死亡风险评分的中位数为 6.0 (3.7–8.9)。主动脉瓣中，二叶式主动脉瓣（BAV）的比例为48.5%。住院期间，卒中发生率为0.7%，植入永久起搏器的高度房室传导阻滞发生率为11.0%。院内全因死亡率为2.2%。 1年后，总体死亡率为4.5%。与三尖瓣主动脉瓣（TAV）患者相比，BAV 患者的院内并发症发生率相似，但院内死亡率（1.4% vs. 3.3%）和 1 年死亡率（2.3% vs. 5.8%）较低。与其他国际注册中心相比，中国的 TAVR 候选者更年轻，BAV 比例更高，术后并发症和死亡率更低。鉴于大多数人群使用早期一代瓣膜，BAV 患者的并发症发生率与 TAV 患者相似，但死亡率较低。这些发现进一步推动了 TAVR 在低风险患者中的推广。 https://www.chictr.org.cn/（编号ChiCTR2000038526）。
The past decade has witnessed an ever-increasing momentum of transcatheter aortic valve replacement (TAVR) and a subsequent paradigm shift in the contemporary management of severe aortic stenosis (AS). We conducted a multi-centric TAVR registry based on Chinese patients (the China Aortic valve tRanscatheter Replacement registrY [CARRY]) to delineate the clinical characteristics and outcomes of Chinese patients who underwent TAVR and compare the results between different valve types in different Chinese regions. CARRY is an all-comer registry of aortic valve disease patients undergoing TAVR across China and was designed as an observational study that retrospectively included all TAVR patients at each participating site. Seven hospitals in China participated in the CARRY, and 1204 patients from April 2012 to November 2020 were included. Categorical variables were compared using the chi-squared test, and continuous variables were analyzed using a t test or analysis of variance (ANOVA) test. The Kaplan–Meier curve was used to estimate the risk of adverse events during follow-up. The mean age of the patients was 73.8 ± 6.5 years and 57.2% were male. The median Society of Thoracic Surgeon-Predicted Risk of Mortality score was 6.0 (3.7–8.9). Regarding the aortic valve, the proportion of bicuspid aortic valve (BAV) was 48.5%. During the hospital stay, the stroke rate was 0.7%, and the incidence of high-degree atrioventricular block indicating permanent pacemaker implantation was 11.0%. The in-hospital all-cause mortality rate was 2.2%. After 1 year, the overall mortality rate was 4.5%. Compared to patients with tricuspid aortic valve (TAV), those with BAV had similar in-hospital complication rates, but a lower incidence of in-hospital mortality (1.4% vs. 3.3%) and 1 year mortality (2.3% vs. 5.8%). TAVR candidates in China were younger, higher proportion of BAV, and had lower rates of post-procedural complications and mortality than other international all-comer registries. Given the use of early generation valves in the majority of the population, patients with BAV had similar rates of complications, but lower mortality than those with TAV. These findings further propel the extension of TAVR in low-risk patients. https://www.chictr.org.cn/ (No. ChiCTR2000038526).