当前位置: X-MOL 学术N. Engl. J. Med. › 论文详情
Five-Year Outcomes of Transcatheter or Surgical Aortic-Valve Replacement.
The New England Journal of Medicine ( IF 70.670 ) Pub Date : 2020-01-29 , DOI: 10.1056/nejmoa1910555
Raj R Makkar,Vinod H Thourani,Michael J Mack,Susheel K Kodali,Samir Kapadia,John G Webb,Sung-Han Yoon,Alfredo Trento,Lars G Svensson,Howard C Herrmann,Wilson Y Szeto,D Craig Miller,Lowell Satler,David J Cohen,Todd M Dewey,Vasilis Babaliaros,Mathew R Williams,Dean J Kereiakes,Alan Zajarias,Kevin L Greason,Brian K Whisenant,Robert W Hodson,David L Brown,William F Fearon,Mark J Russo,Philippe Pibarot,Rebecca T Hahn,Wael A Jaber,Erin Rogers,Ke Xu,Jaime Wheeler,Maria C Alu,Craig R Smith,Martin B Leon,

BACKGROUND There are scant data on long-term clinical outcomes and bioprosthetic-valve function after transcatheter aortic-valve replacement (TAVR) as compared with surgical aortic-valve replacement in patients with severe aortic stenosis and intermediate surgical risk. METHODS We enrolled 2032 intermediate-risk patients with severe, symptomatic aortic stenosis at 57 centers. Patients were stratified according to intended transfemoral or transthoracic access (76.3% and 23.7%, respectively) and were randomly assigned to undergo either TAVR or surgical replacement. Clinical, echocardiographic, and health-status outcomes were followed for 5 years. The primary end point was death from any cause or disabling stroke. RESULTS At 5 years, there was no significant difference in the incidence of death from any cause or disabling stroke between the TAVR group and the surgery group (47.9% and 43.4%, respectively; hazard ratio, 1.09; 95% confidence interval [CI], 0.95 to 1.25; P = 0.21). Results were similar for the transfemoral-access cohort (44.5% and 42.0%, respectively; hazard ratio, 1.02; 95% CI, 0.87 to 1.20), but the incidence of death or disabling stroke was higher after TAVR than after surgery in the transthoracic-access cohort (59.3% vs. 48.3%; hazard ratio, 1.32; 95% CI, 1.02 to 1.71). At 5 years, more patients in the TAVR group than in the surgery group had at least mild paravalvular aortic regurgitation (33.3% vs. 6.3%). Repeat hospitalizations were more frequent after TAVR than after surgery (33.3% vs. 25.2%), as were aortic-valve reinterventions (3.2% vs. 0.8%). Improvement in health status at 5 years was similar for TAVR and surgery. CONCLUSIONS Among patients with aortic stenosis who were at intermediate surgical risk, there was no significant difference in the incidence of death or disabling stroke at 5 years after TAVR as compared with surgical aortic-valve replacement. (Funded by Edwards Lifesciences; PARTNER 2 ClinicalTrials.gov number, NCT01314313.).
更新日期:2020-02-27

 

全部期刊列表>>
智控未来
聚焦商业经济政治法律
跟Nature、Science文章学绘图
控制与机器人
招募海内外科研人才,上自然官网
隐藏1h前已浏览文章
课题组网站
新版X-MOL期刊搜索和高级搜索功能介绍
ACS材料视界
x-mol收录
湖南大学化学化工学院刘松
上海有机所
廖良生
南方科技大学
西湖大学
伊利诺伊大学香槟分校
徐明华
中山大学化学工程与技术学院
试剂库存
天合科研
down
wechat
bug