[TCT2008]第三代CoreValve带来更高的手术成功率

发布于:2008-10-17 10:33

鲁勖

Shawn Lu joined SAIF in Aug 2007. Prior to SAIF, he worked as a business consultant at Accenture. He has also worked for Peking Union Medical College Hospital as a resident surgeon, majored in vascular surgery for 3 years.

Mr. Lu is a register surgeon with the license and holds a M.D. degree from Peking Union Medical College .

第三代CoreValve带来更高的手术成功率

Third-Generation CoreValve Yielded High Procedural Success Rate

关键词:

• 接受18F设备治疗的患者其一年期生存率由于以往产品.

第三代CoreValve自释放经导管人工主动脉瓣在研究中获得了比前代产品更高的手术成功率，以及更低的死亡率。

来自Helios心脏病中心的Ulrich Gerckens教授以及他的研究团队对271名患者进行了大型的单中心研究。10名患者在2004-05年被纳入25F组，24名患者在2005-06期间被纳入21F组，而237名患者在2006年后被纳入18F组。到2008年3月，共有102名连续患者入组18F组。

18F的第三代设备的手术成功率为97.1%（99/102），而死亡率则为0.0%。Gerckens称18F设备的紧急手术的成功率为91.2%（93/102），而21F的第二代设备为70.8%（17/24），25F的第一代设备则为70%（7/10）。

主动脉返流改善率在18F设备组为34.6%，一年期生存率为84.3%，25F和21F组分别为79.2%和60.0%。Gerckens指出，30天死亡率在18F组为10.8%，中风率2.9%。心血管不良事件率和脑血管事件率在18F组为14.7%，21F组为20.8%，25F组为40%。另外，所有组别的患者在术后的纽约心脏病评级均得以改善。

患者特征

18F组患者的平均年龄为81.8岁，其中95.1%的患者纽约心脏病评级为III或IV。在这些患者中，34名（33.3%）既往曾行冠脉搭桥术。患者群的射血分数为51.0±17.3，平均压力梯度为41.6 ±16.4 mm Hg。

（来源：www.tctmd.com）

Third-Generation CoreValve Yielded High Procedural Success Rate

Key Points:

• Patients receiving the 18 F device had better one-year survival than with previous generations.

By TCT Daily Staff

The third generation of the CoreValve self-expanding transcatheter aortic valve yielded lower mortality and higher procedural success rates than previous generations, according to data on patients treated with all three generations of the device.

According to Ulrich Gerckens, MD, a cardiologist at Helios Heart Center in Seigburg, Germany, researchers for the study have enrolled 271 patients in the largest single-center experience for the CoreValve transcatheter valve to date.

Ten patients were enrolled in the 25 F cohort between 2004 and 2005, 24 patients in the 21 F cohort between 2005 and 2006, and 237 in the 18 F cohort beginning in 2006. As of March 2008, 102 consecutive patients were enrolled in the 18 F cohort.

The rate of acute device success for the 18 F/third-generation cohort was 97.1% (99 of 102 patients), with a mortality rate of 0.0%. Gerckens reported an acute procedural success rate of 91.2% (93 of 102) for the 18 F cohort, compared with 70.8% (17 of 24) in the 21 F/second-generation cohort and 70% (seven of 10) in the 25 F/first-generation cohort.

Aortic regurgitation improved in 34.6% of the third-generation patients following implantation; there was no change in 34.6% of patients and worsening in 30.9% of the cohort. One-year survival also was higher in the 18 F cohort (84.3%) than in the 25 F (79.2%) and 21 F (60.0%) groups.

According to Gerckens, rate of death at 30 days in the 18 F cohort was 10.8% (11 of 102), and stroke was 2.9% (3 of 102). There was a lower rate of major adverse CV and cerebrovascular events in the 18 F cohort (14.7%; 15 of 102) compared with the 21 F cohort (20.8%; five of 24) and the 25 F cohort (40%; four of 10). Patients in all cohorts also experienced a reduction in NYHA HF class after receiving the CoreValve device (see Figure).

Patient demographics

The average age of patients enrolled in the 18 F cohort was 81.8 years, with 95.1% (97 of 102) classified as NYHA HF Class III or IV. Of those patients, 34 (33.3%) had CHF and 34 (33.3%) had prior CABG. Patients had an LVEF of 51.0 ±17.3 and a mean pressure gradient of 41.6 ±16.4 mm Hg.

Disclosure statement

• Dr. Gerckens has reported receiving consulting fees and honoraria from CoreValve, Inc.

来源：医心网

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