既往无支架或带支架生物瓣膜患者主动脉瓣介入治疗后的早期和中期结果,Journal of Cardiothoracic Surgery

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既往无支架或带支架生物瓣膜患者主动脉瓣介入治疗后的早期和中期结果
Journal of Cardiothoracic Surgery ( IF 1.5 ) Pub Date : 2023-01-18 , DOI: 10.1186/s13019-023-02118-3
Naoto Fukunaga ₁ , Ali Al-Sarraf ₁ , Khalil Jawad ₁ , Myriam Lafreniere-Roula ₁ , Vivek Rao ₁

Affiliation

关于重新进行主动脉瓣介入治疗的比较结果的可用数据有限，包括使用带支架或无支架生物假体的主动脉瓣置换术 (AVR) 后的手术。我们研究了再次主动脉瓣介入治疗的比较结果，包括 AVR 后使用带支架或无支架生物假体的手术。该队列包括 112 名在 2001 年至 2020 年间因感染性心内膜炎或瓣膜结构退化而接受主动脉瓣介入治疗的患者。100 名患者在初始手术期间接受了支架瓣膜（支架组），12 名患者接受了无支架瓣膜（无支架组）。评估了早期和晚期结果。在当前干预期间，支架组的平均 [IQR] 年龄为 66 [54, 77] 岁，无支架组为 74 [67, 79] 岁 (P = 0.13)。在支架组中，主动脉瓣介入治疗包括带支架瓣膜的重做 AVRs (n = 54)、机械瓣膜 (n = 26)、无支架瓣膜 (n = 16) 和经导管主动脉瓣植入术 (n = 4)。在无支架组中，使用支架瓣膜 (n = 4)、机械瓣膜 (n = 2)、无支架瓣膜 (n = 1) 和经导管瓣膜植入术 (n = 5) 进行重做 AVR。观察到支架组 2 例 (2%) 患者和无支架组 1 例 (8%) 患者的院内死亡率 (P = 0.29)。支架组的 5 年生存率为 80.8% [66.8, 88.5]，无支架组为 91.7% [53.9, 98.8]。观察到组间血栓栓塞的统计学显着差异。

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Early and mid-term outcomes after aortic valve intervention in patients with previous stentless or stented bioprostheses

Limited data are available concerning comparative outcomes of redo aortic valve interventions, including surgery after aortic valve replacement (AVR) with either stented or stentless bioprostheses. We investigated the comparative outcomes of redo aortic valve interventions, including surgery after AVR with either stented or stentless bioprostheses. The cohort consisted of 112 patients who underwent aortic valve intervention for infective endocarditis or structural valve deterioration between 2001 and 2020. One hundred patients received a stented valve (stented group) and 12 patients received a stentless valve (stentless group) during the initial surgery. Early and late outcomes were evaluated. The mean [IQR] ages during the current interventions were 66 [54, 77] years in the stented group and 74 [67, 79] years in the stentless group (P = 0.13). In the stented group, aortic valve interventions included redo AVRs with stented valves (n = 54), mechanical valves (n = 26), stentless valves (n = 16), and transcatheter aortic valve implantations (n = 4). In the stentless group, redo AVRs were performed with stented valves (n = 4), mechanical valves (n = 2), stentless valves (n = 1), and transcatheter valve implantations (n = 5). Hospital mortality was observed in 2 (2%) patients in the stented group and 1 (8%) patients in the stentless group (P = 0.29). The 5-year survival was 80.8% [66.8, 88.5] in the stented group and 91.7% [53.9, 98.8] in stentless group. Statistically significant differences in thromboembolisms were observed between the groups. No significant differences in early and mid-term outcomes (except thromboembolism) after aortic valve interventions were detected between patients with stented and stentless AVRs.

更新日期：2023-01-18

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