Age-related outcomes of transcatheter aortic valve replacement in patients with pure severe aortic regurgitation.

IF 1.9 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Cardiology Pub Date : 2025-02-25 DOI:10.1159/000543567

Jianing Fan, Dawei Lin, Jiaxin Miao, Zilong Weng, Yi-Ming Qi, Zhi Zhan, Mingfei Li, Sha-Sha Chen, Yuliang Long, Nanchao Hong, Yuhao Li, Xiaochun Zhang, Wenzhi Pan, Daxin Zhou, Junbo Ge

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Abstract

Background: Transcatheter aortic valve replacement (TAVR) has emerged as the recommended treatment for older patients with pure severe aortic regurgitation (PSAR). However, the efficacy of TAVR in younger patients with aortic regurgitation (AR) remains unclear. This study explored the therapeutic efficacy and safety of TAVR in these two groups and compared their outcomes.

Methods: Patients with AR who underwent TAVR at Zhongshan Hospital between June 2021 and September 2023 were included and categorized into younger- and older age groups based on whether they were ≥75 years old. The baseline characteristics, clinical test information, and follow-up data of the patients were collected.

Results: A total of 82 patients were included in this study (72.7±7.60 years old, 52[63.4%] male). The younger and older age groups each comprised 41 patients. Young patients had better clinical conditions (diabetes mellitus [0% vs. 17.1%, p=0.006], symptoms [29.3% vs. 70.7%, p=0.025], and permanent pacemaker implantation [PPMI] [0% vs. 9.8%, p=0.040]). Significant improvements in AR as well as left and right heart functions were observed in both groups. A reduced occurrence rate of mild perivalvular leaks (PVL) was observed in the younger age group at the 1-month follow-up visit (2.4% vs. 14.6%; p=0.048).

Conclusion: TAVR is safe and effective for both younger and older patients undergoing PSAR. Younger patients who underwent AR-TAVR experienced fewer perivalvular leaks compared to those experienced by older patients. Therefore, TAVR may be an alternative for younger patients with PSAR. Further Large-scale multicenter prospective studies are needed to validate our findings.

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背景：经导管主动脉瓣置换术（TAVR）已成为纯重度主动脉瓣反流（PSAR）老年患者的推荐治疗方法。然而，经导管主动脉瓣置换术对年轻主动脉瓣反流（AR）患者的疗效仍不明确。本研究探讨了 TAVR 在这两类患者中的疗效和安全性，并比较了他们的治疗结果：方法：纳入2021年6月至2023年9月期间在中山医院接受TAVR的AR患者，根据年龄是否≥75岁将其分为年轻组和老年组。收集了患者的基线特征、临床检查信息和随访数据：本研究共纳入 82 例患者（72.7±7.60 岁，男性 52 例[63.4%]）。年轻组和老年组各占 41 例。年轻患者的临床条件更好（糖尿病[0% vs. 17.1%，P=0.006]、症状[29.3% vs. 70.7%，P=0.025]和永久起搏器植入[PPMI][0% vs. 9.8%，P=0.040]）。两组患者的 AR 以及左右心功能均有显著改善。在1个月的随访中，年轻组的轻度瓣周漏（PVL）发生率降低（2.4% vs. 14.6%; p=0.048）：结论：TAVR对于接受PSAR的年轻和年长患者都是安全有效的。与老年患者相比，接受 AR-TAVR 的年轻患者瓣周漏较少。因此，TAVR 可能是年轻 PSAR 患者的一种选择。需要进一步开展大规模多中心前瞻性研究来验证我们的发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiology 医学-心血管系统

CiteScore

3.40

自引率

5.30%

发文量

审稿时长

1.5 months

期刊介绍： ''Cardiology'' features first reports on original clinical, preclinical and fundamental research as well as ''Novel Insights from Clinical Experience'' and topical comprehensive reviews in selected areas of cardiovascular disease. ''Editorial Comments'' provide a critical but positive evaluation of a recent article. Papers not only describe but offer critical appraisals of new developments in non-invasive and invasive diagnostic methods and in pharmacologic, nutritional and mechanical/surgical therapies. Readers are thus kept informed of current strategies in the prevention, recognition and treatment of heart disease. Special sections in a variety of subspecialty areas reinforce the journal''s value as a complete record of recent progress for all cardiologists, internists, cardiac surgeons, clinical physiologists, pharmacologists and professionals in other areas of medicine interested in current activity in cardiovascular diseases.