Transapical aortic valve implantation in 100 consecutive patients: comparison to propensity-matched conventional aortic valve replacement
Transapical aortic valve implantation in 100 consecutive patients: comparison to propensity-matched conventional aortic valve replacement
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DOI：
10.1093/eurheartj/ehq060
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发表时间：
2010-06-01
影响因子：
39.3
通讯作者：
Mohr, Friedrich W.
中科院分区：
文献类型：
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作者：
Walther, Thomas;Schuler, Gerhard;Mohr, Friedrich W.
为评价经心尖部主动脉瓣置入术(TA-AVI)与传统手术的疗效，自2006年2月至2008年1月，连续100例有症状性主动脉瓣狭窄的高危患者接受了使用Edwards SAPIEN(TM)异种心包的TA-AVI。患者年龄为82.7+/-5岁，其中77名女性，Logistic EuroSCORE预测的死亡风险为29.4+/-13%，社会胸科医生的死亡风险评分为15.2+/-8.3%。采用倾向性评分分析确定接受常规主动脉瓣置换术(C-AVR)的对照组。97例患者经心尖部主动脉瓣植入术成功，3例患者需早期中转。TA-AVI组无新发神经事件，82例患者早期拔管。超声心动图显示所有患者瓣膜功能良好，跨瓣压差低。TA-AVI组与C-AVR组30天存活率分别为90+/-3和85+/-4%，一年存活率分别为73+/-4和69+/-5%(P=0.55)。经心尖部主动脉瓣置入术是治疗高危主动脉狭窄患者的一种安全、微创、非体外循环的方法。在最初的100例患者中，结果是好的，与传统手术相比是好的。
To evaluate the outcome of transapical aortic valve implantation (TA-AVI) in comparison to conventional surgery.One hundred consecutive high-risk patients with symptomatic aortic valve stenosis received TA-AVI using the Edwards SAPIEN (TM) pericardial xenograft between February 2006 and January 2008. Patient age was 82.7 +/- 5 years, 77 were females, logistic EuroSCORE predicted risk of mortality was 29.4 +/- 13% and Society Thoracic Surgeons score risk for mortality was 15.2 +/- 8.3%. Propensity score analysis was used to identify a control group of patients that underwent conventional aortic valve replacement (C-AVR). Transapical aortic valve implantation was performed successfully in 97 patients, whereas three patients required early conversion. There were no new onset neurological events in the TA-AVI group and early extubation was performed in 82 patients. Echocardiography revealed good valve function with low transvalvular gradients in all patients. Thirty-day survival was 90 +/- 3 vs. 85 +/- 4% for TA-AVI vs. C-AVR, and 1-year survival was 73 +/- 4 vs. 69 +/- 5% (P = 0.55).Transapical aortic valve implantation is a safe, minimally invasive, and off-pump technique to treat high-risk patients with aortic stenosis. Results of the initial 100 patients are good and compare favourably to conventional surgery.