Predictors and Outcomes After Transcatheter Aortic Valve Implantation Using Different Approaches According to the Valve Academic Research Consortium Definitions
Predictors and Outcomes After Transcatheter Aortic Valve Implantation Using Different Approaches According to the Valve Academic Research Consortium Definitions
复制标题
DOI：
10.1002/ccd.24751
复制
发表时间：
2013-10-01
影响因子：
2.3
通讯作者：
Treede, Hendrik
中科院分区：
文献类型：
--
作者：
Seiffert, Moritz;Schnabel, Renate;Treede, Hendrik
目的根据瓣膜学术研究联盟 (VARC)，我们报告了一项大型单中心研究的结果，该研究评估了经导管主动脉瓣植入 (TAVI) 后使用不同设备和进入路径的预测因素和结果。背景 TAVI 的广泛采用需要对结果进行系统分析。只有很少的综合数据比较心脏团队选择的不同方法。 方法对 326 名连续患者（平均年龄 80.6±7.1 岁，55.5% 女性）进行 TAVI 手术，这些患者处于高风险状态，通过经股动脉或经心尖入路使用球囊扩张和自扩张装置进行手术。根据 VARC 终点分析数据；确定了死亡率的预测因素。结果尽管基线风险概况不同，但总体死亡率为 10.1%（30 天）和 29.9%（1 年），在瓣膜或通路选择方面具有可比性（P = 0.295）。 87.1% 和 21.2% 的患者实现了设备成功和 30 天安全终点。心肌梗死[风险比 (HR) 6.52]、2 期和 -3 期急性肾损伤（HR 2.52 和 6.80）以及主要穿刺部位并发症（HR 1.96）是 1 年全因死亡率的独立预测因素。装置的成功具有保护作用（HR 0.58）。基线预测因素包括体重指数
ObjectivesWe report the results of a large single-center study evaluating predictors and outcomes after transcatheter aortic valve implantation (TAVI) with different devices and access routes according to the Valve Academic Research Consortium (VARC).BackgroundThe widespread adoption of TAVI warrants a systematic analysis of outcomes. Only few comprehensive data exist comparing different approaches as selected by a heart team.MethodsTAVI was performed in 326 consecutive patients (mean age 80.6 7.1 years, 55.5% female) at high risk for surgery with balloon-expandable and self-expanding devices through transfemoral or transapical access. Data were analyzed according to VARC endpoints; predictors of mortality were identified.ResultsAll-cause mortality was 10.1% (30 days) and 29.9% (1 year) overall and comparable with regard to valve or access choice (P = 0.295) despite different risk profiles at baseline. Device success and 30-day safety endpoints were achieved in 87.1 and 21.2%. Myocardial infarction [hazard ratio (HR) 6.52], stage-2 and -3 acute kidney injury (HR 2.52 and 6.80) and major access site complications (HR 1.96) were independent predictors of 1-year all-cause mortality. Device success had a protective effect (HR 0.58). Baseline predictors included body mass index