JACC. Cardiovascular interventions · 2026
Long-Term Outcomes of Contemporary Balloon-Expandable TAVR in Bicuspid Aortic Valve: A Propensity-Matched Comparison to Tricuspid.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Suruga Kazuki, Patel Vivek, Shitan Hidemasa, Yuchao Guo, Nagasaka Takashi, Ng Daniel, Menda Jaideep, Singh Adishwar, Goyal Ayush, Buss Elijah, Kremenovic Andjela, Dermand Emily, Jain Harsh, Patel Dhairya, Gupta Aakriti, Chakravarty Tarun, Cheng Wen, Okada Yuito, Jilaihawi Hasan, Nakamura Mamoo, Makkar Raj R
Аннотация
BACKGROUND: Limited data are available comparing clinical outcomes between bicuspid and tricuspid patients following transcatheter aortic valve replacement (TAVR).
OBJECTIVES: This study sought to investigate 5-year clinical outcomes in patients with severe aortic stenosis following TAVR with contemporary balloon-expandable valves (BEVs) in patients with bicuspid vs tricuspid leaflet morphology.
METHODS: From August 2015 to December 2023, a total of 3,393 patients with native aortic stenosis who underwent TAVR with contemporary BEVs were divided into bicuspid and tricuspid groups. A 1:1 propensity score-matched analysis was performed to adjust for baseline differences. The primary endpoint was all-cause mortality at 5-year follow-up.
RESULTS: Among 515 matched pairs, over a median follow-up duration of 1,511 days (Q1-Q3: 937-1825 days), there were no significant differences in all-cause mortality (13.2% vs 13.7%; P = 0.384). Heart failure rehospitalization (8.5% vs 6.8%; P = 0.622), stroke (2.4% vs 2.6%; P = 0.618), or aortic valve reintervention (0.7% vs 1.6%; P = 0.706) at 5 years was not significantly different between the groups. Ascending aortic growth rates (0.37 mm/y vs 0.31 mm/y; P = 0.578), in-hospital death (0.8% vs 1.0%; P = 0.738), valve hemodynamics through 5 years, including mean transvalvular gradients (12.0 mm Hg vs 11.5 mm Hg; P = 0.863), effective orifice area (1.35 cm2 vs 1.50 cm2, P = 0.084), and moderate or greater paravalvular leak (3.9% vs 5.6%; P = 0.578) did not differ significantly between groups.
CONCLUSIONS: In propensity score-matched patients undergoing TAVR with contemporary BEVs, long-term clinical outcomes, valve performance, and ascending aortic growth rate showed no statistically significant differences between bicuspid and tricuspid groups.
OBJECTIVES: This study sought to investigate 5-year clinical outcomes in patients with severe aortic stenosis following TAVR with contemporary balloon-expandable valves (BEVs) in patients with bicuspid vs tricuspid leaflet morphology.
METHODS: From August 2015 to December 2023, a total of 3,393 patients with native aortic stenosis who underwent TAVR with contemporary BEVs were divided into bicuspid and tricuspid groups. A 1:1 propensity score-matched analysis was performed to adjust for baseline differences. The primary endpoint was all-cause mortality at 5-year follow-up.
RESULTS: Among 515 matched pairs, over a median follow-up duration of 1,511 days (Q1-Q3: 937-1825 days), there were no significant differences in all-cause mortality (13.2% vs 13.7%; P = 0.384). Heart failure rehospitalization (8.5% vs 6.8%; P = 0.622), stroke (2.4% vs 2.6%; P = 0.618), or aortic valve reintervention (0.7% vs 1.6%; P = 0.706) at 5 years was not significantly different between the groups. Ascending aortic growth rates (0.37 mm/y vs 0.31 mm/y; P = 0.578), in-hospital death (0.8% vs 1.0%; P = 0.738), valve hemodynamics through 5 years, including mean transvalvular gradients (12.0 mm Hg vs 11.5 mm Hg; P = 0.863), effective orifice area (1.35 cm2 vs 1.50 cm2, P = 0.084), and moderate or greater paravalvular leak (3.9% vs 5.6%; P = 0.578) did not differ significantly between groups.
CONCLUSIONS: In propensity score-matched patients undergoing TAVR with contemporary BEVs, long-term clinical outcomes, valve performance, and ascending aortic growth rate showed no statistically significant differences between bicuspid and tricuspid groups.
Предметные рубрики MeSH
HumansTime FactorsTreatment OutcomeAortic Valve StenosisAortic ValveHeart Valve ProsthesisRisk FactorsBicuspid Aortic Valve DiseaseFemaleProsthesis DesignBalloon ValvuloplastyAged, 80 and overTranscatheter Aortic Valve ReplacementMaleRisk AssessmentSeverity of Illness IndexAgedRetrospective StudiesTricuspid ValveRecovery of FunctionHeart Valve DiseasesPostoperative ComplicationsPropensity Score