Liming Zhu1, Yingqiang Guo2, Wei Wang3, Huan Liu1, Ye Yang1, Lai Wei4, Chunsheng Wang5. 1. Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai, China. 2. Department of Cardiovascular Surgery, West China Hospital, Chengdu, Sichuan, China. 3. Department of Cardiac Surgery, Fu Wai Cardiovascular Hospital, Beijing, China. 4. Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai, China. Electronic address: wei.lai@zs-hospital.sh.cn. 5. Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai, China. Electronic address: zswangcs@126.com.
Abstract
OBJECTIVES: The clinical experience of a novel transapical transcatheter aortic valve replacement system, the J-Valve (JC Medical Inc, Burlingame, Calif), in high-risk patients with severe aortic valve diseases is limited. METHODS: A total of 107 high-risk patients (mean age, 74.4 ± 5.2 years) underwent transcatheter aortic valve replacement with the J-Valve from March 2014 to July 2015, which included 63 patients with aortic stenoses and 44 patients with aortic regurgitation. Echocardiography and contrast-enhanced computed tomography were used to evaluate patients' baseline characteristics and their follow-up conditions. RESULTS: The J-Valve was successfully implanted in 102 patients (95.3%). Five patients (4.7%) underwent conversion to open surgery. The overall mortality was 4.7% (n = 5) at both 30 days and 6 months, whereas subgroup mortality was 6.3% (n = 4) in the aortic stenosis group and 2.3% (n = 1) in the aortic regurgitation group. Permanent pacemakers were implanted in 5 patients (4.7%). In the aortic stenosis group, paravalvular regurgitation was observed as none or trace in 54.2% of patients (n = 32), mild in 42.4% of patients (n = 25), and moderate in 3.4% of patients (n = 2) postprocedure. The mean aortic gradient decreased from 56.7 ± 15.2 mm Hg to 14.4 ± 7.8 mm Hg (P < .01). The peak aortic valve velocity declined from 4.76 ± 0.6 m/s to 2.45 ± 0.57 m/s (P < .01). In the patients with aortic regurgitation, paravalvular regurgitation was none or trace in 74.4% (n = 32), mild in 23.3% (n = 10), and 2.3% (n = 1) after the procedure. Mean aortic gradient was 7.1 ± 2.9 mm Hg. CONCLUSIONS: Transcatheter aortic valve replacement by the J-Valve is an adequate clinical option to treat high-risk patients with severe aortic stenosis or aortic regurgitation.
OBJECTIVES: The clinical experience of a novel transapical transcatheter aortic valve replacement system, the J-Valve (JC Medical Inc, Burlingame, Calif), in high-risk patients with severe aortic valve diseases is limited. METHODS: A total of 107 high-risk patients (mean age, 74.4 ± 5.2 years) underwent transcatheter aortic valve replacement with the J-Valve from March 2014 to July 2015, which included 63 patients with aortic stenoses and 44 patients with aortic regurgitation. Echocardiography and contrast-enhanced computed tomography were used to evaluate patients' baseline characteristics and their follow-up conditions. RESULTS: The J-Valve was successfully implanted in 102 patients (95.3%). Five patients (4.7%) underwent conversion to open surgery. The overall mortality was 4.7% (n = 5) at both 30 days and 6 months, whereas subgroup mortality was 6.3% (n = 4) in the aortic stenosis group and 2.3% (n = 1) in the aortic regurgitation group. Permanent pacemakers were implanted in 5 patients (4.7%). In the aortic stenosis group, paravalvular regurgitation was observed as none or trace in 54.2% of patients (n = 32), mild in 42.4% of patients (n = 25), and moderate in 3.4% of patients (n = 2) postprocedure. The mean aortic gradient decreased from 56.7 ± 15.2 mm Hg to 14.4 ± 7.8 mm Hg (P < .01). The peak aortic valve velocity declined from 4.76 ± 0.6 m/s to 2.45 ± 0.57 m/s (P < .01). In the patients with aortic regurgitation, paravalvular regurgitation was none or trace in 74.4% (n = 32), mild in 23.3% (n = 10), and 2.3% (n = 1) after the procedure. Mean aortic gradient was 7.1 ± 2.9 mm Hg. CONCLUSIONS: Transcatheter aortic valve replacement by the J-Valve is an adequate clinical option to treat high-risk patients with severe aortic stenosis or aortic regurgitation.