Transapical transcatheter aortic valve implantation for predominant aortic regurgitation with a self-expandable valve.

Abstract

BACKGROUND:

Transcatheter aortic valve implantation (TAVI) has become the gold standard for high-risk severe aortic stenosis. However, the experience of treating aortic regurgitation (AR) with this technology is still limited. Previously, we have demonstrated excellent 1-year outcomes of transapical TAVI with J-ValveTM (JieCheng Medical Technology Co., Ltd., Suzhou, China) in treating predominant AR, while the mid-term outcomes up to 4 years have never been reported.

METHODS:

Transapical TAVI with J-ValveTM to treat predominant AR was performed in 47 patients in Zhongshan Hospital from May 2014 through October 2018. Procedural and clinical outcomes with follow-up up to 4 years were analyzed using Valve Academic Research Consortium-2 criteria (VARC-2).

RESULTS:

All patients (age 73.7±7.9 years) were considered to be prohibitive or high-risk for surgical aortic valve replacement (SAVR) (logistic European System for Cardiac Operative Risk Evaluation, 21.1% to 44.4%; mean, 24.3%±5.1%) after evaluated by a multidisciplinary heart team. Transapical implantations were successful in all patients. The clinical outcomes of the entire cohort in the latest follow-up (371 to 1,968 days, median 574 days) included all-cause mortality (6.4%), disabling stroke (2.3%), new permanent pacemaker (6.8%) and valve-related re-intervention (0). Paravalvular leak (PVL) was rate as none or trace in 37 of 44 and mild in 7 of 44 patients at the latest follow-up. Mean transvalvular gradient was favorable after valve implantation during follow-up at 9.3±2.5 mmHg.

CONCLUSIONS:

This study revealed that, transapical TAVI with J-ValveTM for treating AR has encouraging mid-term outcomes, and the advantages at one year demonstrated in previous study can be maintained through 4 years.

• Authors: Huan Liu, Shun Liu, Yuntao Lu, Ye Yang, Wenshuo Wang, Liming Zhu, Lai Wei, Chunsheng Wang
• Journal: Journal of thoracic disease (J Thorac Dis) Vol. 12 Issue 3 Pg. 538-549 (Mar 2020) ISSN: 2072-1439 [Print] China
• PMID: 32274119 (Publication Type: Journal Article)
• Copyright: 2020 Journal of Thoracic Disease. All rights reserved.