6 results on '"Zhao, Zhen-Gang"'
Search Results
2. Differences in metabolic profiles between bicuspid and tricuspid aortic stenosis in the setting of transcatheter aortic valve replacement
- Author
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Xiong, Tian-Yuan, Liu, Chang, Liao, Yan-Biao, Zheng, Wen, Li, Yi-Jian, Li, Xi, Ou, Yuanweixiang, Wang, Zi-Jie, Wang, Xi, Li, Chang-Ming, Zhao, Zhen-Gang, Feng, Yuan, Liu, Xiao-Jing, and Chen, Mao
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- 2020
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3. Snaring Self-Expanding Devices to Facilitate Transcatheter Aortic Valve Replacement in Patients with Complex Aortic Anatomies.
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Yao, Yi-Jun, Zhao, Zhen-Gang, Wang, Xi, Peng, Yong, Wei, Jia-Fu, He, Sen, Li, Yi-Jian, He, Jing-Jing, Zhu, Zhong-Kai, Feng, Yuan, and Chen, Mao
- Subjects
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CARDIAC pacemakers , *HEART valve prosthesis implantation , *AORTA , *MITRAL valve , *AORTIC valve , *PROPENSITY score matching , *AORTIC stenosis - Abstract
The snare-assisted technique has been described to facilitate transcatheter aortic valve replacement (TAVR) delivery system advancement in complex aortic anatomies. However, the evidence is limited to case reports. To evaluate the safety profile of the snare-facilitated approach and its impact on self-expanding (SE) TAVR outcomes, we collected consecutive patients who underwent transfemoral SE-TAVR for aortic stenosis, using propensity score matching (PSM) separately in tricuspid and type-0 and type-1 bicuspid aortic valve morphology between the snare and non-snare groups. In 766 patients, despite the snare group having significantly larger annulus angulation and maximal ascending aortic diameter, both groups achieved comparable 30-day device success rates, regardless of first-generation or new-generation valve use. After PSM, the snare group had a significantly lower new permanent pacemaker implantation rate among 193 type-0 patients (3.3% vs. 18.3%, p = 0.01). The ipsilateral group used new-generation valves less frequently (23.0% vs. 75.4%, p < 0.001), but there were no significant inter-group differences in procedure-related events, except for a lower incidence of PVL ≥ mild in the ipsilateral group (14.9% vs. 32.3%, p = 0.01). In conclusion, the snare-assisted technique appears useful in SE-TAVR with angulated aortic root anatomy, and the benefits were comparable between ipsilateral and contralateral snare techniques. [ABSTRACT FROM AUTHOR]
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- 2023
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4. Sex Difference in Outcomes Following Transcatheter Aortic Valve Replacement in Bicuspid Aortic Stenosis.
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He, Jing-Jing, Xiong, Tian-Yuan, Yao, Yi-Jun, Peng, Yong, Wei, Jia-Fu, He, Sen, Chen, Yong, Li, Qiao, Zhao, Zhen-Gang, Wei, Xin, Zhou, Wen-Xia, Liang, Yu-Jia, Tang, Hong, Chen, Guo, Zhou, Xuan, Zheng, Ming-Xia, Meng, Wei, Liao, Yan-Biao, Li, Yi-Jian, and Li, Yi-Ming
- Abstract
It is unknown whether the sex difference whereby female transcatheter aortic valve replacement (TAVR) candidates had a lower risk profile, a higher incidence of in-hospital complications, but more favorable short- and long-term survival observed in tricuspid cohorts undergoing TAVR would persist in patients with bicuspid aortic valves (BAVs). The aim of this study was to reexamine the impact of sex on outcomes following TAVR in patients with BAVs. In this single-center study, patients with BAVs undergoing TAVR for severe aortic stenosis from 2012 to 2021 were retrospectively included. Baseline characteristics, aortic root anatomy, and in-hospital and 1-year valve hemodynamic status and survival were compared between sexes. A total of 510 patients with BAVs were included. At baseline, women presented with fewer comorbidities. Men had a greater proportion of Sievers type 1 BAV, higher calcium volumes (549.2 ± 408.4 mm
3 vs 920.8 ± 654.3 mm3 ; P < 0.001), and larger aortic root structures. Women experienced more vascular complications (12.9% vs 4.9%; P = 0.002) and bleeding (11.1% vs 5.3%; P = 0.019) and higher residual gradients (16.9 ± 7.7 mm Hg vs 13.2 ± 6.4 mm Hg; P < 0.001), while men were more likely to undergo second valve implantations during index TAVR (6.3% vs 15.9%; P = 0.001). Death at 1 year was not significantly different between sexes (HR: 1.15; 95% CI: 0.56-2.35; P = 0.70). Bleeding (adjusted HR: 4.62; 95% CI: 1.51-14.12; P = 0.007) was the single independent predictor of 1-year death for women. In patients with BAVs undergoing TAVR, women presented with fewer comorbidities, while men had a greater proportion of type 1 BAV, more calcification, and larger aortic roots. In-hospital outcomes favored men, with fewer complications except for the need for second valve implantation, but 1-year survival was comparable between sexes. [Display omitted] [ABSTRACT FROM AUTHOR]- Published
- 2022
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5. Permanent pacemaker implantation after transcatheter aortic valve replacement in bicuspid aortic valve patients.
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Xiong, Tian‐Yuan, Liao, Yan‐Biao, Li, Yi‐Jian, Zhao, Zhen‐Gang, Wei, Xin, Tsauo, Jiay‐yu, Xu, Yuan‐Ning, Feng, Yuan, Chen, Mao, Xiong, Tian-Yuan, Liao, Yan-Biao, Li, Yi-Jian, Zhao, Zhen-Gang, Tsauo, Jiay-Yu, and Xu, Yuan-Ning
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AORTIC valve ,CARDIAC surgery ,CHEMOEMBOLIZATION ,AORTIC stenosis ,HEART valves ,AORTIC valve surgery ,AORTIC valve abnormalities ,ARRHYTHMIA ,CARDIAC pacemakers ,PROSTHETIC heart valves ,HEART valve diseases ,RESEARCH funding ,TREATMENT effectiveness ,DISEASE incidence ,RETROSPECTIVE studies ,MULTIDETECTOR computed tomography - Abstract
Background: Studies of permanent pacemaker implantation (PPI) after transcatheter aortic valve replacement (TAVR) specifically for bicuspid aortic valve (BAV) patients are lacking. We aim to delineate possible aspects that might affect the incidence of PPI in a retrospective cohort of BAV patients treated with early-generation self-expanding devices.Methods: A total of 80 patients with bicuspid morphology who successfully underwent TAVR by self-expanding devices without prior PPI were included. Baseline clinical, echocardiographic, and angiographic characteristics, procedural and post-procedural details were collected.Results: The incidence of PPI after early-generation self-expanding valves in this BAV cohort was 26.3%. Baseline characteristics were comparable between patients requiring PPI post-TAVR or not. Perimeter oversizing greater than 20% significantly increased the risk of PPI compared with an oversizing of 10-20% (OR 5.08 [1.22, 21.07], P = 0.03). The proportion of patients with a depth of implantation greater than 6 mm was significantly higher in those who required PPI (82.4% vs 54.3%, P = 0.04). When testing the impact of depth of implantation >6 mm and oversizing in different morphologies, only in type 1 bicuspid patients and by oversizing>20% increased the risk of PPI (OR 12.00 [1.25, 115.36], P = 0.03) compared with an oversizing of 10-20%.Conclusions: Excessive perimeter oversizing in relation to aortic annulus and depth of implantation greater than 6 mm should be avoided to improve PPI post-TAVR for BAV patients receiving self-expanding devices, especially for type 1 BAV. [ABSTRACT FROM AUTHOR]- Published
- 2018
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6. GW24-e1746 Transcatheter aortic valve implantation in high-risk patients with severe bicuspid aortic valve stenosis: Feasibility, safety and efficacy
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Chen Mao, Huang De-jia, Zhao Zhen-gang, Wei Xin, Tang Hong, Xu Yuan-ning, and Feng Yuan
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medicine.medical_specialty ,business.industry ,Periprosthetic ,Hemodynamics ,Regurgitation (circulation) ,medicine.disease ,Surgery ,Stenosis ,Bicuspid aortic valve ,Aortic valve replacement ,Internal medicine ,medicine ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,Contraindication ,Survival rate - Abstract
Objectives We sought to assess the feasibility and outcomes of transcatheter aortic valve implantation (TAVI) in the setting of bicuspid aortic valves (BAVs), which were regarded as a relative contraindication. Methods Consecutive patients with severe BAV stenosis, who underwent TAVI at West China Hospital between April 2012 and March 2013, were included for analysis. Their procedural, hemodynamic and clinical outcomes were presented according to the standardised definitions of the Valvular Academic Research Consortium-2 (VARC-2). Results A total of 12 patients (mean age, 73 years; 9 men and 3 women) with symptomatic BAV stenosis were identified. All patients were deemed unsuitable for conventional aortic valve replacement due to high perceived surgical risk, as was testified by the mean logistic EuroSCORE of 36.1%. TAVI was performed through a transfemoral and transsubclavian access in 11 and 1 patient, respectively. The Medtronic CoreValve was successfully implanted for all patients with the exception of one, in whom the prosthetic valve failed to expand properly due to the heavily calcified native leaflets and was retracted safely without adverse effects. There was no intraprocedural or periprocedural (within 72 hours following TAVI) death. Striking hemodynamic improvements were observed after TAVI. The mean (± standard deviation) aortic-valve gradient reduced from 57.7 ± 9.3 mmHg to 13.1 ± 5.4 mmHg, and the peak jet velocity decreased from 4.8 ± 0.5 m/s to 2.3 ± 0.6 m/s. Marginal moderate periprosthetic regurgitation occurred in 1 patient. Using the VARC-2 definition, the device success rate was 83.3% (10 of 12). Permanent pacemakers were implanted in 4 patients (33.3%) owing to third-degree atrioventricular blocks. One patient was attacked by ischaemic stroke 4 days after TAVI, but recovered without significant neurological sequelae at discharge. Another patient suffered from minor vascular complication (or minor bleeding) and died suddenly 20 days after TAVI. Afterwards, no further death was observed. Thus the survival rate was 91.7% at 30 days and remained unchanged at a median follow-up over 200 days to date. Conclusions TAVI using the CoreValve is feasible, safe and associated with satisfactory mid-term clinical outcomes in selected high-risk patients with severely stenotic BAVs, but the long-term outcomes remain to be evaluated.
- Published
- 2013
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