Chen, Yang, Ferdous, Md Misbahul, Kottu, Lakshme, Zhao, Jie, Zhang, Hong Liang, Wang, Mo Yang, Niu, Guan Nan, Liu, Qing Rong, Zhou, Zheng, Zhao, Zhen Yan, Zhang, Qian, Feng, De Jing, Zhang, Bin, Li, Zi Ang, Merkus, Daphne, Lv, Bin, Xu, Hai Yan, Song, Guang Yuan, Wu, Yong Jian, Chen, Yang, Ferdous, Md Misbahul, Kottu, Lakshme, Zhao, Jie, Zhang, Hong Liang, Wang, Mo Yang, Niu, Guan Nan, Liu, Qing Rong, Zhou, Zheng, Zhao, Zhen Yan, Zhang, Qian, Feng, De Jing, Zhang, Bin, Li, Zi Ang, Merkus, Daphne, Lv, Bin, Xu, Hai Yan, Song, Guang Yuan, and Wu, Yong Jian
Introduction: Chronic severe aortic regurgitation (AR) has a poor long-term prognosis, especially among old-age patients. Considering their advancing age, the surgical approach of aortic valve replacement may not always be the best alternative modality of treatment in such patients. Therefore, this study’s primary goal was to provide an initial summary of the medium- and short-term clinical effectiveness of transcatheter aortic valve replacement (TAVR) guided by accurate multi-detector computed tomography (MDCT) measurements in patients with severe and chronic AR, especially in elderly patients. Methods: The study enrolled retrospectively and prospectively patients diagnosed with severe AR who eventually underwent TAVR procedure from January 2019 to September 2022 at Fuwai cardiovascular Hospital, Beijing. Baseline information, MDCT measurements, anatomical classification, perioperative, and 1-year follow-up outcomes were collected and analyzed. Based on a novel anatomical categorization and dual anchoring theory, patients were divided into four categories according to the level of anchoring area. Type 1, 2, and 3 patients (with at least two anchoring regions) will receive TAVR with a transcatheter heart valve (THV), but Type 4 patients (with zero or one anchoring location) will be deemed unsuitable for TAVR and will instead receive medical care (retrospectively enrolled patients who already underwent TAVR are an exception). Results: The mean age of the 37 patients with severe chronic AR was 73.1 ± 8.7 years, and 23 patients (62.2%) were male. The American Association of Thoracic Surgeons’ score was 8.6 ± 2.1%. The MDCT anatomical classification included 17 cases of type 1 (45.9%), 3 cases of type 2 (8.1%), 13 cases of type 3 (35.1%), and 4 cases of Type 4 (10.8%). The VitaFlow valve (MicroPort, Shanghai, China) was implanted in 19 patients (51.3%), while the Venus A valve (Venus MedTech, Hangzhou, China) was implanted in 18 patients (48.6%). Immediate TAVR proce