Transapical transcatheter aortic valve replacement for aortic regurgitation with a second-generation heart valve.

Abstract

OBJECTIVE:

To report on the Chinese multicenter study of the J-Valve transcatheter heart valve for treatment of predominant aortic regurgitation.

METHODS:

Transapical transcatheter aortic valve replacement with the J-Valve for treating high-risk severe aortic regurgitation was performed in 43 patients in 3 Chinese centers. The study was registered with the Chinese Clinical Trial Registry (ChiCTR-OPC-15006354). Procedural results and clinical outcomes up to 1-year were analyzed using Valve Academic Research Consortium 2 criteria.

RESULTS:

All patients (mean age, 73.9 ± 5.7 years) were considered at prohibitive or high risk for surgical valve replacement (logistic European System for Cardiac Operative Risk Evaluation, 20.0% to 44.4%; mean, 25.5% ± 5.3%) after evaluation by an interdisciplinary heart team. Transapical implantation was successful in 42 patients (97.7%). The 1-year outcomes included all-cause mortality (4.7%), disabling stroke (2.3%), new permanent pacemaker (4.7%), and valve-related reintervention (7.0%). At the 1-year follow-up, postprocedural paravalvular regurgitation was none/trace in 30 of 39 patients and mild in 8 of 39 patients, and the mean transvalvular gradient after valve implantation was favorable at 10.4 ± 4.5 mm Hg.

CONCLUSIONS:

After an initial demonstration of feasibility, this multicenter study shows that the J-Valve transcatheter heart valve system is a reasonable option for patients with predominant aortic regurgitation.

• Authors: Huan Liu, Ye Yang, Wenshuo Wang, Da Zhu, Lai Wei, Kefang Guo, Weipeng Zhao, Xue Yang, Liming Zhu, Yingqiang Guo, Wei Wang, Chunsheng Wang
• Journal: The Journal of thoracic and cardiovascular surgery (J Thorac Cardiovasc Surg) Vol. 156 Issue 1 Pg. 106-116 (07 2018) ISSN: 1097-685X [Electronic] United States
• PMID: 29525255 (Publication Type: Journal Article, Multicenter Study, Observational Study, Video-Audio Media)
• Copyright: Copyright © 2018 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Topics

• Aged
• Aortic Valve (diagnostic imaging, physiopathology, surgery)
• Aortic Valve Insufficiency (diagnostic imaging, physiopathology, surgery)
• China
• Echocardiography, Doppler, Color
• Echocardiography, Transesophageal
• Feasibility Studies
• Female
• Heart Valve Prosthesis
• Hemodynamics
• Humans
• Male
• Multidetector Computed Tomography
• Postoperative Complications (therapy)
• Prospective Studies
• Prosthesis Design
• Recovery of Function
• Risk Factors
• Time Factors
• Transcatheter Aortic Valve Replacement (adverse effects, instrumentation)
• Treatment Outcome