Abstract
ObjectiveThe aim of the current study was to evaluate the early experience of the application of transcatheter aortic valve implantation with the balloon-expandable system in China. The transcatheter aortic valve implantation technology has been widely used for patients with inoperable severe aortic stenosis in the developed world. The application of transcatheter aortic valve implantation is still in the early stages of testing in China, particularly for the balloon-expandable valve procedure.MethodsThis was a retrospective study. All patients undergoing transcatheter aortic valve implantation with balloon-expandable system in our hospital between 2011 and 2014 were included. Edwards SAPIEN XT Transcatheter Heart Valve was used. The improvement of valve and heart function was evaluated as well as 30-day mortality and major complications according to the VARC-2 definition.ResultsA total of 10 transcatheter aortic valve implantation procedures with the balloon-expandable system were performed in our hospital, of which 9 were transfemoral and 1 was transapical. The median age was 76 years, and the median STS score and Logistic EuroSCORE (%) were 8.9 and 16.2. The implantation was successfully conducted in all patients, only 2 patients had mild paravalvular leak. There was no second valve implantation. Moreover, no 30-day mortality or complications was reported. Following the transcatheter aortic valve implantation procedure, the heart and valve functions had improved significantly. During the follow-up period of 3-34 months, one patient died of lung cancer 13 months after the operation.ConclusionThis early experience has provided preliminary evidence for the safety and efficacy of transcatheter aortic valve implantation procedure with the balloon-expandable system in the developing world with an increasing aging population.
Highlights
During the past 50 years, the etiology of valvular heart diseases has changed greatly in developed countries, with an increase in non-rheumatic valvular heart diseases such as age-related calcific aortic stenosis (AS)[1,2]
In China, limited data indicated that the prevalence of rheumatic heart disease was 10 times higher than developed countries in 2002[4], the rapid growth of an aging population increases the number of vulnerable age-related AS
Since 2007, more than 100,000 patients have been treated by transcatheter aortic valve replacement (TAVR) worldwide[15], most of whom were from developed countries
Summary
During the past 50 years, the etiology of valvular heart diseases has changed greatly in developed countries, with an increase in non-rheumatic valvular heart diseases such as age-related calcific aortic stenosis (AS)[1,2]. In China, limited data indicated that the prevalence of rheumatic heart disease was 10 times higher than developed countries in 2002[4], the rapid growth of an aging population increases the number of vulnerable age-related AS. The conventional SAVR has excellent outcomes[8,9,10], it has been reported that patients with severe symptomatic AS had higher mortality when treated by SAVR[11,12]. The emergence and rapid development of transcatheter aortic valve replacement (TAVR) indicated hope for those inoperable or high-risk patients[13,14]. A recent meta-analysis estimated that approximately 290,000 elderly patients are TAVR candidates in European countries and North America[16].
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