کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2979656 1578610 2014 8 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Hemodynamic performance and outcome of percutaneous versus surgical stentless bioprostheses for aortic stenosis with anticipated patient–prosthesis mismatch
ترجمه فارسی عنوان
عملکرد همودینامیک و نتایج بیوپروتزهای بدون استنتلیال در مقابل جراحی برای تنگی آئورت با عدم انطباق پیش بینی شده پروتز بیمار
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
چکیده انگلیسی

ObjectivesWe aimed to compare the performance and midterm survival of transcutaneous aortic valve replacement (TAVR) and surgically implanted stentless aortic valve replacement (SAVR) for severe aortic stenosis in patients anticipated to have patient–prosthesis mismatch (PPM).MethodsA retrospective analysis was performed of 86 and 49 consecutive TAVR and SAVR patients with severe aortic stenosis and calculated minimal effective orifice area larger than the best projected effective orifice area. Cox hazard analyses were used to assess the effect of TAVR versus SAVR on outcome.ResultsThe peak and mean transprosthetic gradient at discharge were lower (P < .001 for both) in the TAVR group. Mild or greater aortic regurgitation was more frequent in the TAVR group (61% vs 7%; P < .0001). At 3 months of follow-up, the mean gradient in the TAVR group was similar to that of the SAVR group but the prevalence of aortic regurgitation was still higher. The unadjusted 3-year survival rate was superior in the SAVR versus TAVR group (91.6% ± 4% vs 67.0% ± 7%; P = .01). Adjustments for both age and comorbidity resulted in loss of the difference in mortality between the 2 groups.ConclusionsIn patients with anticipated PPM, TAVR offers an immediate lower incidence of PPM than SAVR but a greater prevalence of aortic regurgitation. The differences in transaortic gradients became nonsignificant 3 months postoperatively. The question of whether TAVR is a suitable substitute for SAVR in patients with anticipated PPM, in particular, those who are older and sicker, warrants additional investigation.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: The Journal of Thoracic and Cardiovascular Surgery - Volume 147, Issue 6, June 2014, Pages 1892–1899
نویسندگان
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