Early outcome of transapical transcatheter aortic valve replacement for aortic insufficiency_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

SHI Yinglu ,  ZHANG Chengxin , GUO Zhixiang , GONG Wenhui , GE Shenglin

Department of Cardiac and Vascular Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, P. R. China;

Corresponding author：

ZHANG Chengxin, Email: 13485604116@sohu.com

Keywords：

Transcatheter aortic valve replacement; aortic insufficiency; aortic stenosis; transapical approach

DOI：

10.7507/1007-4848.202212037

Video：

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Objective To assess the early outcome of transapical transcatheter aortic valve replacement (TAVR) for patients with aortic insufficiency. Methods The patients with aortic valvular disease who underwent transapical TAVR from October 2020 to October 2022 in the Department of Cardiac and Vascular Surgery, the First Affiliated Hospital of Anhui Medical University were enrolled in the current retrospective study. The patients with aortic stenosis were assembled in a group A, and the patients with aortic insufficiency were assembled in a group B. The improvements of heart function and complications were assessed for the two groups. Results A total of 56 patients were enrolled, including 32 males and 24 females with an average age of 73.34±5.10 years. There were 31 patients in the group A and 25 patients in the group B. There was no statistical difference between the two groups in the age, gender, height, weight, hypertension, coronary artery disease, peripheral vascular disease, chronic obstructive pulmonary disease, renal disorder or classification of heart function (P>0.05). Also, there was still no statistical difference in the rate of permanent peacemaker implants, emergent open surgery, valve re-implants, or perivalvular leakage (P>0.05). After TAVR, the left ventricular diastolic diameter, left ventricular ejection fraction, complicated moderated mitral and tricuspid regurgitation were significantly improved in both groups compared with preoperative findings (P<0.05); however, there was no statistical difference in these parameters between groups (P>0.05). Conclusion Interventional valve (J-Valve) in the treatment of patients with aortic insufficiency through transapical TAVR significantly improves cardiac function and reduces functional valve regurgitation.

Citation： SHI Yinglu, ZHANG Chengxin, GUO Zhixiang, GONG Wenhui, GE Shenglin. Early outcome of transapical transcatheter aortic valve replacement for aortic insufficiency. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2023, 30(8): 1116-1120. doi: 10.7507/1007-4848.202212037 Copy

1.	王云涛, 王立成, 李少珂, 等. 高危主动脉瓣狭窄患者经导管主动脉瓣置换与外科主动脉瓣置换术的短期临床疗效分析. 心肺血管病杂志, 2021, 40(8): 832-836.
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4.	Mack MJ, Leon MB, Thourani VH, et al. Transcatheter aortic-valve replacement with a balloon-expandable valve in low-risk patients. N Engl J Med, 2019, 380(18): 1695-1705.
5.	Silaschi M, Conradi L, Wendler O, et al. The JUPITER registry: One-year outcomes of transapical aortic valve implantation using a second generation transcatheter heart valve for aortic regurgitation. Catheter Cardiovasc Interv, 2018, 91(7): 1345-1351.
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7.	张辉, 张华, 赵建明, 等. 单中心61例经导管主动脉瓣置换的结果分析. 中国心血管病研究, 2021, 19(11): 970-974.
8.	Eftychiou C, Eteocleous N, Zittis I, et al. Outcomes of transfemoral transcatheter aortic valve implantation (TAVI) and predictors of thirty-day major adverse cardiovascular events (MACE) and one-year mortality. Hellenic J Cardiol, 2021, 62(1): 57-64.
9.	Wongpraparut N, Sakiyalak P, Jakrapanichakul D, et al. Ten years experience of transcatheter aortic valvereplacement at the Faculty of Medicine Siriraj Hospital: Transapical vs. transfemoral approach. J Med Associat Thail, 2021, 11(5): 846-852.
10.	Hu Z, Huang B, Jiang H, et al. Modified valve-in-valve bailout technique of transcatheter aortic valve replacement in severe aortic regurgitation for valve jumping up to ascending aorta: A case report. Eur Heart J Case Rep, 2022, 6(8): ytac327.
11.	薛云星, 李树春, 金珉, 等. J-Valve经心尖导管内瓣膜置入术治疗复杂瓣膜疾病. 中华胸心血管外科杂志, 2021, 37(6): 372-374.
12.	Iliuta L, Andronesi AG, Diaconu CC, et al. Diastolic versus systolic left ventricular dysfunction as independent predictors for unfavorable postoperative evolution in patients with aortic regurgitation undergoing aortic valve replacement. Medicina (Kaunas), 2022, 58(11): 1676.
13.	Benfari G, Setti M, Nistri S, et al. Relevance of functional mitral regurgitation in aortic valve stenosis. Am J Cardiol, 2020, 136: 115-121.
14.	Agricola E, Ielasi A, Oppizzi M, et al. Long-term prognosis of medically treated patients with functional mitral regurgitation and left ventricular dysfunction. Eur J Heart Fail, 2009, 11(6): 581-587.
15.	Benfari G, Antoine C, Miller WL, et al. Excess mortality associated with functional tricuspid regurgitation complicating heart failure with reduced ejection fraction. Circulation, 2019, 140(3): 196-206.

1. 王云涛, 王立成, 李少珂, 等. 高危主动脉瓣狭窄患者经导管主动脉瓣置换与外科主动脉瓣置换术的短期临床疗效分析. 心肺血管病杂志, 2021, 40(8): 832-836.
2. Webb JG, Murdoch DJ, Alu MC, et al. 3-year outcomes after valve-in-valve transcatheter aortic valve replacement for degenerated bioprostheses: The PARTNER 2 registry. J Am Coll Cardiol, 2019, 73(21): 2647-2655.
3. Popma JJ, Deeb GM, Yakubov SJ, et al. Transcatheter aortic-valve replacement with a self-expanding valve in low-risk patients. N Engl J Med, 2019, 380(18): 1706-1715.
4. Mack MJ, Leon MB, Thourani VH, et al. Transcatheter aortic-valve replacement with a balloon-expandable valve in low-risk patients. N Engl J Med, 2019, 380(18): 1695-1705.
5. Silaschi M, Conradi L, Wendler O, et al. The JUPITER registry: One-year outcomes of transapical aortic valve implantation using a second generation transcatheter heart valve for aortic regurgitation. Catheter Cardiovasc Interv, 2018, 91(7): 1345-1351.
6. Vahanian A, Beyersdorf F, Praz F, et al. 2021 ESC/EACTS guidelines for the management of valvular heart disease. Eur J Cardiothorac Surg, 2021, 60(4): 727-800.
7. 张辉, 张华, 赵建明, 等. 单中心61例经导管主动脉瓣置换的结果分析. 中国心血管病研究, 2021, 19(11): 970-974.
8. Eftychiou C, Eteocleous N, Zittis I, et al. Outcomes of transfemoral transcatheter aortic valve implantation (TAVI) and predictors of thirty-day major adverse cardiovascular events (MACE) and one-year mortality. Hellenic J Cardiol, 2021, 62(1): 57-64.
9. Wongpraparut N, Sakiyalak P, Jakrapanichakul D, et al. Ten years experience of transcatheter aortic valvereplacement at the Faculty of Medicine Siriraj Hospital: Transapical vs. transfemoral approach. J Med Associat Thail, 2021, 11(5): 846-852.
10. Hu Z, Huang B, Jiang H, et al. Modified valve-in-valve bailout technique of transcatheter aortic valve replacement in severe aortic regurgitation for valve jumping up to ascending aorta: A case report. Eur Heart J Case Rep, 2022, 6(8): ytac327.
11. 薛云星, 李树春, 金珉, 等. J-Valve经心尖导管内瓣膜置入术治疗复杂瓣膜疾病. 中华胸心血管外科杂志, 2021, 37(6): 372-374.
12. Iliuta L, Andronesi AG, Diaconu CC, et al. Diastolic versus systolic left ventricular dysfunction as independent predictors for unfavorable postoperative evolution in patients with aortic regurgitation undergoing aortic valve replacement. Medicina (Kaunas), 2022, 58(11): 1676.
13. Benfari G, Setti M, Nistri S, et al. Relevance of functional mitral regurgitation in aortic valve stenosis. Am J Cardiol, 2020, 136: 115-121.
14. Agricola E, Ielasi A, Oppizzi M, et al. Long-term prognosis of medically treated patients with functional mitral regurgitation and left ventricular dysfunction. Eur J Heart Fail, 2009, 11(6): 581-587.
15. Benfari G, Antoine C, Miller WL, et al. Excess mortality associated with functional tricuspid regurgitation complicating heart failure with reduced ejection fraction. Circulation, 2019, 140(3): 196-206.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Early outcome of transapical transcatheter aortic valve replacement for aortic insufficiency

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