新一代球囊可扩张经导管心脏瓣膜的早期结果- Myval系统:塞尔维亚的单中心经验

Boljevic Darko, Bojic Milovan, Farkic Mihajlo, Sagić Dragan, Hinic Sasa, Topic Dragan, Dobric Milan, Lakcevic Jovana, Nikolić Marko, Veljkovic Stefan, Furtula Matija, Kljajevic Jelena, Nikolic Aleksandra
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摘要

经导管主动脉瓣植入术(TAVI)是治疗严重主动脉瓣狭窄(AVS)最有效的方法之一。不同类型和世代的经导管心脏瓣膜(THV)可供使用,为操作员提供了选择患者定制设备的机会。在这项单中心研究中,我们介绍了塞尔维亚患者接受下一代Myval THV治疗严重症状性AVS的结果。在2020年10月至2021年9月期间,在塞尔维亚贝尔格莱德Dedinje心血管研究所接受TAVI的所有连续患者中植入了Myval THV。主要终点是第30天的设备成功。次要终点包括30天全因死亡率、心血管死亡、中风、中度/重度瓣膜周漏(PVL)和新型永久性起搏器植入(PPI)。TAVI按照欧洲心脏病学会指南进行。该研究包括13名患者,年龄为72±13岁,平均EuroSCORE评分(7.17%),胸科医生协会评分(2.72%),他们成功地接受了TAVI,其中92.3%使用了经皮入路。分别有46%和15%的患者植入了Myval中等尺寸和超大尺寸THV。该急性手术成功率为100%。所有患者都达到了早期装置成功的主要复合终点。无一例患者出现临床意义的主动脉瓣反流或中度/重度PVL。没有患者出现中风、造影剂诱导的急性肾损伤、器械相关血管并发症或新的PPI。30天时的全因死亡率为0%。在塞尔维亚的一个中心,Myval THV系统在手术后30天内显示出良好的安全性/有效性。这是我在塞尔维亚使用Myval THV的第一份报告。
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Early Outcomes of a Next-Generation Balloon-Expandable Transcatheter Heart Valve - The Myval System: A Single-Center Experience From Serbia
Transcatheter aortic valve implantation (TAVI) is one of the most effective treatments for severe aortic valve stenosis (AVS). Different genres and generations of transcatheter heart valves (THVs) are accessible, offering operators an opportunity to choose a patient-tailored device. In this single-center study, we present the outcomes of Serbian patients treated with next-generation Myval THV for severe symptomatic AVS. Myval THV was implanted in all consecutive patients who underwent TAVI at the Dedinje Cardiovascular Institute of Belgrade, Serbia between October 2020 and September 2021. The primary endpoint was device success on day 30. Secondary endpoints included 30-day all-cause mortality, cardiovascular death, stroke, moderate/severe paravalvular leak (PVL), and new permanent pacemaker implantation (PPI). TAVI was performed as per the European Society of Cardiology guidelines. The study comprised thirteen patients, aged 72 ± 13 years with mean EuroSCORE (7.17%) and Society of Thoracic Surgeons (2.72%,) scores who underwent TAVI successfully with 92.3% using the percutaneous approach. Myval THV intermediate and extra-large sizes were implanted in 46% and 15% of patients, respectively. This acute procedure success rate was 100%. The primary composite endpoint of early device success was achieved in all patients. None of the patients had clinically significant aortic regurgitation or moderate/severe PVL. No patient experienced stroke, contrast-induced acute kidney injury, device-related vascular complications, or a new PPI. The all-cause mortality rate at 30 days was 0%. Myval THV system demonstrated a favorable safety/efficacy profile within 30 days post-procedure at a single center in Serbia. This is the first report of my experience with Myval THV from Serbia.
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