Original Article   

The Journal of Cardiovascular Surgery 2022 Apr 07

DOI: 10.23736/S0021-9509.22.11260-7

Copyright © 2022 EDIZIONI MINERVA MEDICA

lingua: Inglese

Initial experience with repositionable J-Valve for severe aortic regurgitation: a single-center experience

Lulu LIU ¹, Ying PENG ², Jun SHI ¹, Hong QIAN ¹,Yingqiang GUO ¹ ✉

¹ Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China; ² Department of Cardiology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, China

BACKGROUND: This study aimed to evaluate the clinical outcomes of treating high-risk patients presenting with severe aortic regurgitation (AR) or aortic stenosis (AS) using transcatheter aortic valve replacement (TAVR).
METHODS: This retrospective study included 290 consecutive patients with symptomatic severe aortic regurgitation or aortic stenosis. All patients who underwent TAVR with J-Valve at our institution between March 2014 and July 2019. Preoperative demographic data, clinical and echocardiographic parameters, procedural parameters, postoperative clinical outcomes, and echocardiographic parameters were recorded retrospectively.
RESULTS: The study included a total of 290 participants 161 patients were had severe aortic regurgitation and 129 patients had severe aortic stenosis. The baseline characteristics of the two groups were similar. The device success rate was high for both aortic regurgitation and aortic stenosis groups (95.0% vs 93.0%, p = 0.47). All-cause mortality of both groups conditions were similar at 30 days (1.9% vs 3.9%, p = 0.48). Patients treated for aortic regurgitation had a higher incidence of pacemaker implantation compared to the aortic stenosis group (8.3% vs. 0.8%, p<0.01) at 30 days postoperation. There was no significant difference between the groups in moderate or severe paravalvular leakage (1.9% vs. 0, p=0.13). The use of larger prostheses was more common in the aortic regurgitation group compared to the aortic stenosis group (66.5% vs. 13.2%, p＜0.01). Mean pressure gradient was lower in the aortic stenosis group (8.5±2.9 vs. 12.9±6.6, p < 0.01), but structural valve deterioration was more common in the aortic stenosis group (9.7% vs. 0, p<0.01) at 30 days post-op.
CONCLUSIONS: In this study, we found that the prognosis of patients with aortic regurgitation is comparable to that of patients with aortic stenosis after TAVR with J-valve. For patients with severe aortic regurgitation or aortic stenosis, TAVR is an effective therapeutic option. Pacemaker rate in the aortic regurgitation group was higher, but structural valve deterioration is was more common in aortic stenosis patients.

KEY WORDS: Aortic regurgitation/insufficiency; Transcatheter aortic valve implantation; J-Valve