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On-line Access: 2023-06-13

Received: 2022-09-05

Revision Accepted: 2023-01-20

Crosschecked: 2023-07-21

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Citations:  Bibtex RefMan EndNote GB/T7714

 ORCID:

Jian-an Wang

https://orcid.org/0000-0002-4583-3204

Xianbao LIU

https://orcid.org/0000-0003-1556-9198

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Journal of Zhejiang University SCIENCE B 2023 Vol.24 No.6 P.530-538

http://doi.org/10.1631/jzus.B2200444


Cerebral ischemic injury after transcatheter aortic valve replacement in patients with pure aortic regurgitation


Author(s):  Xianbao LIU, Hanyi DAI, Jiaqi FAN, Dao ZHOU, Gangjie ZHU, Abuduwufuer YIDILISI, Jun CHEN, Yeming XU, Lihan WANG, Jian'an WANG

Affiliation(s):  Department of Cardiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China; more

Corresponding email(s):   wangjianan111@zju.edu.cn

Key Words:  Cerebral ischemic injury, Transcatheter aortic valve replacement, Pure aortic regurgitation, Transfemoral, Transapical


Xianbao LIU, Hanyi DAI, Jiaqi FAN, Dao ZHOU, Gangjie ZHU, Abuduwufuer YIDILISI, Jun CHEN, Yeming XU, Lihan WANG, Jian'an WANG. Cerebral ischemic injury after transcatheter aortic valve replacement in patients with pure aortic regurgitation[J]. Journal of Zhejiang University Science B, 2023, 24(6): 530-538.

@article{title="Cerebral ischemic injury after transcatheter aortic valve replacement in patients with pure aortic regurgitation",
author="Xianbao LIU, Hanyi DAI, Jiaqi FAN, Dao ZHOU, Gangjie ZHU, Abuduwufuer YIDILISI, Jun CHEN, Yeming XU, Lihan WANG, Jian'an WANG",
journal="Journal of Zhejiang University Science B",
volume="24",
number="6",
pages="530-538",
year="2023",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B2200444"
}

%0 Journal Article
%T Cerebral ischemic injury after transcatheter aortic valve replacement in patients with pure aortic regurgitation
%A Xianbao LIU
%A Hanyi DAI
%A Jiaqi FAN
%A Dao ZHOU
%A Gangjie ZHU
%A Abuduwufuer YIDILISI
%A Jun CHEN
%A Yeming XU
%A Lihan WANG
%A Jian'an WANG
%J Journal of Zhejiang University SCIENCE B
%V 24
%N 6
%P 530-538
%@ 1673-1581
%D 2023
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B2200444

TY - JOUR
T1 - Cerebral ischemic injury after transcatheter aortic valve replacement in patients with pure aortic regurgitation
A1 - Xianbao LIU
A1 - Hanyi DAI
A1 - Jiaqi FAN
A1 - Dao ZHOU
A1 - Gangjie ZHU
A1 - Abuduwufuer YIDILISI
A1 - Jun CHEN
A1 - Yeming XU
A1 - Lihan WANG
A1 - Jian'an WANG
J0 - Journal of Zhejiang University Science B
VL - 24
IS - 6
SP - 530
EP - 538
%@ 1673-1581
Y1 - 2023
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B2200444


Abstract: 
Considering the surgical risk stratification for patients with severe calcific aortic stenosis (AS), transcatheter aortic valve replacement (TAVR) is a reliable alternative to surgical aortic valve replacement (SAVR) (Fan et al., 2020, 2021; Lee et al., 2021). Despite the favorable clinical benefits of TAVR, stroke remains a dreaded perioperative complication (Auffret et al., 2016; Kapadia et al., 2016; Kleiman et al., 2016; Huded et al., 2019). Ischemic overt stroke, identified in 1.4% to 4.3% of patients in TAVR clinical practice, has been associated with prolonged disability and increased mortality (Auffret et al., 2016; Kapadia et al., 2016; Levi et al., 2022). The prevalence of hyperintensity cerebral ischemic lesions detected by diffusion-weighted magnetic resonance imaging (DW-MRI) was reported to be about 80%, which is associated with impaired neurocognitive function and vascular dementia (Vermeer et al., 2003; Barber et al., 2008; Kahlert et al., 2010).

经导管主动脉瓣置换术治疗单纯主动脉瓣反流患者术后脑损伤

刘先宝1,2,戴晗怡1,2,范嘉祺1,周道1,2,朱钢杰1,2,Abuduwufuer YIDILISI1,2,陈俊1,2,许烨铭1,2,王力涵1,王建安1,2
1浙江大学医学院第二附属医院心内科, 中国杭州市,310009
2浙江大学医学院附属医学院内科学, 中国杭州市,310058
摘要:
目的:本研究旨在比较重度主动脉瓣狭窄(AS)和单纯主动脉瓣反流(AR)患者接受经导管主动脉瓣置换术(TAVR)后发生脑损伤的风险。
方法:回顾性分析287例AS和65例单纯AR接受TAVR的患者。患者在TAVR术前和术后3天进行头颅磁共振检查。
结果:本研究中57.7%为男性;单纯AR患者年龄较小(71岁vs.74岁;P=0.001),美国心胸外科医师协会评分较低(2.39 vs. 3.89;P<0.001);3.1%的患者在出院前发生了症状性脑卒中;单纯AR组脑损伤病灶发生率(83.1% vs. 85.0%;P=0.695),病灶数(3.0 (1.5~7.5) vs. 3.0 (1.0~8.0);P=0.928)和总体积(130.0 mm3 vs. 190.0 mm3P=0.585)与AS组相比差异无统计学意义;此外,单纯AR组中的经股动脉入路和经心尖入路相比,无论是病灶数(3.0 (2.0~7.0) vs. 3.5 (1.0~8.3);P=0.923)还是总体积(120.0 mm3 vs. 135.0 mm3P=0.837)均相似。多元广义泊松回归模型证实吸烟史、慢性肾脏病4期或5期、左室流出道钙化是单纯AR患者TAVR术后脑损伤病灶数的独立预测因素。
结论:AS组与单纯AR组相比,TAVR术后新发脑损伤病灶的发生率、数量及总体积差异均无统计学意义。

关键词:脑损伤;经导管主动脉瓣置换术;单纯主动脉瓣反流;经股动脉入路;经心尖入路

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

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