使用 J-Valve 系统经导管主动脉瓣植入术治疗严重主动脉瓣反流:中期随访研究。

IF 2.1 3区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Catheterization and Cardiovascular Interventions Pub Date : 2024-09-09 DOI:10.1002/ccd.31196
Min Jin MD, Haitao Zhang MD, Qing Zhou MD, PhD, Shuchun Li MD, PhD, Dongjin Wang MD, PhD
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引用次数: 0

摘要

背景:经导管主动脉瓣植入术(TAVI)是一种治疗严重主动脉瓣狭窄的成熟干预方法。然而,其对严重主动脉瓣反流(AR)的应用仍在评估中。目的:本研究旨在评估J-瓣膜系统治疗重度主动脉瓣反流的中期疗效和耐久性,并提供有关该介入治疗的新信息:在这项回顾性单中心研究中,我们评估了在南京鼓楼医院接受J-活瓣系统治疗的AR患者的预后结果。接受过 J-Valve 治疗的患者均被纳入分析范围。研究重点是超声心动图随访,以评估J-活瓣系统管理AR的有效性和耐久性:从2018年1月到2022年12月,36名高风险AR患者接受了J-Valve系统治疗,手术成功率为97.2%,其中一例患者因瓣膜移位需要进行开胸手术。左心室直径明显改善(从 63.50 [58.75-69.50] mm 降至 56.50 [53.00-60.50] mm,p 结论:J-瓣膜系统显示出良好的治疗效果:J-Valve 系统在治疗 AR 方面取得了积极的疗效,在控制病情方面效果显著,并显著改善了心衰症状和心脏重塑。然而,由于样本量有限且随访数据不全面,必须强调需要进一步开展全面的长期随访研究,以充分验证这些结果。
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Transcatheter aortic valve implantation for severe aortic regurgitation using the J-Valve system: A midterm follow-up study

Background

Transcatheter aortic valve implantation (TAVI) is a well-established intervention for severe aortic valve stenosis. However, its application for severe aortic regurgitation (AR) is still under evaluation. This study aims to present the 3-year follow-up outcomes of the J-Valve system in managing severe AR.

Aims

The aim of this study was to evaluate the mid-term efficacy and durability of the J-Valve system in the treatment of severe AR and to provide new information on this intervention.

Methods

In this retrospective, single-center study, we evaluated the prognostic outcomes of patients with AR, who underwent treatment with the J-Valve system at Nanjing Drum Tower Hospital. Consecutive patients who were treated with the J-Valve were included in the analysis. The study focused on the echocardiographic follow-up to assess the effectiveness and durability of the J-Valve system in managing AR.

Results

From January 2018 to December 2022, 36 high-risk AR patients treated with the J-Valve system had a procedural success rate of 97.2%, with one case requiring open-heart surgery due to valve displacement. Significant improvements were observed in left ventricular diameter (from 63.50 [58.75–69.50] mm to 56.50 [53.00–60.50] mm, p < 0.001) and left atrial diameter (from 44.00 [40.00–45.25] mm to 39.00 [36.75–41.00] mm, p = 0.003) postsurgery. All patients completed the 1-year follow-up, with an overall mortality rate of 2 out of 36 (5.6%). Among the surviving patients, there was one case of III° atrioventricular block and one case of stroke, both occurring within 90 days postsurgery. After a 3-year follow-up, 15.0% of patients had mild or moderate valvular regurgitation, with no cases of moderate or severe paravalvular leak. Additionally, 89.5% of patients were classified as New York Heart Association class I or II, showing significantly enhanced cardiac function.

Conclusion

The J-Valve system has shown positive therapeutic outcomes in treating AR, with notable effectiveness in managing the condition and significant improvements in heart failure symptoms and cardiac remodeling. However, due to the limited sample size and partial follow-up data, it is important to emphasize the need for further research with comprehensive long-term follow-up, to fully validate these results.

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来源期刊
CiteScore
5.40
自引率
8.70%
发文量
419
审稿时长
2 months
期刊介绍: Catheterization and Cardiovascular Interventions is an international journal covering the broad field of cardiovascular diseases. Subject material includes basic and clinical information that is derived from or related to invasive and interventional coronary or peripheral vascular techniques. The journal focuses on material that will be of immediate practical value to physicians providing patient care in the clinical laboratory setting. To accomplish this, the journal publishes Preliminary Reports and Work In Progress articles that complement the traditional Original Studies, Case Reports, and Comprehensive Reviews. Perspective and insight concerning controversial subjects and evolving technologies are provided regularly through Editorial Commentaries furnished by members of the Editorial Board and other experts. Articles are subject to double-blind peer review and complete editorial evaluation prior to any decision regarding acceptability.
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