Yunxing Xue1, Qing Zhou1, Shuchun Li1, Jie Li2, Dan Mu3, Xuan Luo1, Chang Liu1, Can Xu1, Dongjin Wang4. 1. Department of Cardiothoracic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing, China; Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, China. 2. Department of Ultrasound, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing, China. 3. Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing, China. 4. Department of Cardiothoracic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing, China; Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, China. Electronic address: dongjinwang_gl@163.com.
Abstract
BACKGROUND: The J-Valve system (Jie ChengMedical Technologies, Suzhou, China) is designed specifically for transapical transcatheter aortic valve replacement and has three U-shaped graspers. With the unique structure, the J-Valve is suitable for both aortic stenosis and aortic regurgitation. We used the J-Valve system for patients with aortic valve diseases and observed favorable results. METHODS: From January 2018 to August 2019, 23 patients underwent transapical transcatheter valve replacement using the J-Valve system. High-risk patients with diseased peripheral vessels (small diameter, heavily calcified, and tortuous arteries), pure aortic regurgitation, and complex prosthetic valve-in-valve cases were enrolled. Ten patients mainly had aortic stenosis, 11 patients had pure aortic regurgitation, and 2 patients had valve-in-valve aortic valve position. The Society of Thoracic Surgeons and European System for Cardiac Operative Risk Evaluation average preoperative scores were 8.9% and 8.7%, respectively. RESULTS: The technique success rate was 91.3% (21 of 23; 1 patient was referred for open surgery and 1 patient received intraoperative valve-in-valve), and 1 patient died of cardiogenic shock after the procedure (mortality 4.3%, 1 of 22). One patient had stroke postoperatively and recovered well; no cases needed to undergo permanent pacemaker implantation. During the follow-up period, 1 patient died of acute heart attack. No moderate or severe paravalvular leakage was found. CONCLUSIONS: Transcatheter aortic valve replacement surgery with the J-Valve system is effective, even when it is traumatic and requires the transapical route. The applicability of the J-Valve system in pure aortic regurgitation patients is the advantage of this system.
BACKGROUND: The J-Valve system (Jie ChengMedical Technologies, Suzhou, China) is designed specifically for transapical transcatheter aortic valve replacement and has three U-shaped graspers. With the unique structure, the J-Valve is suitable for both aortic stenosis and aortic regurgitation. We used the J-Valve system for patients with aortic valve diseases and observed favorable results. METHODS: From January 2018 to August 2019, 23 patients underwent transapical transcatheter valve replacement using the J-Valve system. High-risk patients with diseased peripheral vessels (small diameter, heavily calcified, and tortuous arteries), pure aortic regurgitation, and complex prosthetic valve-in-valve cases were enrolled. Ten patients mainly had aortic stenosis, 11 patients had pure aortic regurgitation, and 2 patients had valve-in-valve aortic valve position. The Society of Thoracic Surgeons and European System for Cardiac Operative Risk Evaluation average preoperative scores were 8.9% and 8.7%, respectively. RESULTS: The technique success rate was 91.3% (21 of 23; 1 patient was referred for open surgery and 1 patient received intraoperative valve-in-valve), and 1 patientdied of cardiogenic shock after the procedure (mortality 4.3%, 1 of 22). One patient had stroke postoperatively and recovered well; no cases needed to undergo permanent pacemaker implantation. During the follow-up period, 1 patientdied of acute heart attack. No moderate or severe paravalvular leakage was found. CONCLUSIONS: Transcatheter aortic valve replacement surgery with the J-Valve system is effective, even when it is traumatic and requires the transapical route. The applicability of the J-Valve system in pure aortic regurgitationpatients is the advantage of this system.
Authors: Neil Robertson; Lorenzo Sempere; Elizabeth Kenyon; Christiane Mallet; Kylie Smith; Jeremy Hix; Alan Halim; Jinda Fan; Anna Moore Journal: Mol Imaging Biol Date: 2022-09-07 Impact factor: 3.484