METHODS: All adult patients who underwent AVN (AVN group) or surgical aortic valve replacement (SAVR) with a bioprosthetic valve (SAVR group) between 2015 and 2022 were identified. Propensity score matching was used to adjust the baseline characteristics between the 2 groups.
RESULTS: A total of 101 patients underwent AVN, and 1816 patients underwent SAVR with a bioprosthetic valve. None in the AVN group required conversion to SAVR. Before matching, mean age in the AVN group was 68.5 ± 8.8 years, and 56 patients (55.4%) underwent concomitant procedures. Preoperatively, 3 (3%) had endocarditis. Bicuspid valve was observed in 38 (38.4%). None died at 30 days in the AVN group. The median follow-up duration was 3.2 years. After propensity score matching, the expected survival and freedom from at least moderate aortic regurgitation at 5 years was 91.7% ± 3.1% and 97.6% ± 1.7%, respectively. Propensity score matching yielded 77 patients in each group. The Kaplan-Meier curve demonstrated equivalent survival at 5 years between the 2 groups (P = .95). Additionally, freedom from at least moderate aortic regurgitation was comparable at 5 years (P = .23).
CONCLUSIONS: AVN can be safely performed for a variety of aortic valve diseases, with or without concomitant operations. AVN demonstrated similar midterm outcomes compared with SAVR with a bioprosthetic valve in the United States adult population.
方法:所有接受AVN(AVN组)或SAVR生物瓣膜(SAVR组)的成年患者均在2015年至2022年之间进行鉴定。使用倾向评分匹配来调整两组之间的基线特征。
结果:共有101例患者接受了AVN,1,816例患者接受了生物人工瓣膜的SAVR。AVN组中没有要求转换为SAVR。匹配之前,AVN组的平均年龄为68.5±8.8岁,56例(55.4%)患者接受了伴随手术。术前,3(3%)有心内膜炎。38例(38.4%)观察到二尖瓣。在AVN组中没有人在30天死亡。中位随访时间为3.2年。PSM之后,5年至少中度主动脉瓣返流的预期生存率和自由度分别为91.7±3.1%和97.6±1.7%,分别。倾向评分匹配每组有77名患者。Kaplan-Meier曲线显示两组间5年生存率相同(P=.95)。此外,5年时至少没有中度主动脉瓣反流的情况相当(P=.23).
结论:AVN可以安全地用于各种主动脉瓣疾病,有或没有伴随手术。在美国成年人群中,与使用生物人工瓣膜的SAVR相比,AVN显示出相似的中期结果。