经导管主动脉瓣置换术应用于二、三叶式主动脉瓣狭窄的疗效比较

李玄庶; 徐东辉; 冯翔; 王旭; 潘湘斌

doi:10.12125/j.chj.202301017

经导管主动脉瓣置换术应用于二、三叶式主动脉瓣狭窄的疗效比较

Outcomes in transcatheter aortic valve replacement for bicuspid versus tricuspid aortic valve stenosis

摘要

摘要:
目的比较经导管主动脉瓣置换术（transcatheter aortic valve replacement, TAVR）治疗二、三叶式主动脉瓣狭窄患者的围术期及短期临床结局。
方法回顾统计2018年1月～2020年12月就诊于阜外医院接受TAVR治疗的179患者，经过筛选及倾向性评分匹配后，二、三叶式主动脉瓣组分别有51例病例，分析比较两组患者在围手术期及术后1年结局事件发生率的差异。
结果尽管二叶式主动脉瓣组术后瓣周中重度返流的发生率高于三叶式主动脉瓣组（11.8% vs. 2.0%，无统计学意义），但两组在手术技术成功率（80.4% vs. 84.3%，无统计学意义）、术后30 d主要临床事件复合终点发生率（3.9% vs. 3.9%，无统计学意义）以及术后1年主要终点事件发生率（9.67% vs. 6.74%，无统计学意义）的差异均无统计学意义。
结论与三叶式主动脉瓣相比，二叶式主动脉瓣狭窄患者接受TAVR在围术期及短期结局等方面无明显差异。

Abstract:
AIM To compare the procedural and clinical outcomes in patients with bicuspid versus tricuspid aortic valve stenosis.
METHODS We collected medical records of 179 patients who received transcatheter aortic valve replacement (TAVR) in Fuwai Hospital from January 2018 to December 2020 retrospectively. After screening and propensity-score matching, outcomes of 51 pairs of patients were compared.
RESULTS There were no significant difference between the two groups in the rate of device success (80.4% vs. 84.3%, no statistical significance), the incidence of 30-day major clinical endpoints (3.9% vs. 3.9%, no statistical significance) and the incidence of primary endpoint (9.67% vs. 6.74%, no statistical significance), while the incidence of the moderate of severe paravalvular leak was slightly higher in the bicuspid group (11.8% vs. 2.0%, no statistical significance).
CONCLUSION There is no significant difference in procedural and short-term outcomes between TAVR for tricuspid aortic valve stenosis and TAVR for bicuspid aortic valve stenosis.

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