13partnertrialpresentationslides-資料下載頁
2025-02-26 02:11本頁面
【正文】 cedure None TraceMildModerate SevereNo. at Risk % % % % % % % % % Mortality in Patients with NoneTrace AR (AT) TAVR vs AVR TAVR 131 121 114 102 93 80 63 AVR 256 205 192 184 165 147 109 0%10%20%30%40%50%60%70%0 6 12 18 24 30 36Mortality Months post Procedure TAVRAVRNo. at Risk % % % % HR [95% CI] = [, ] p (log rank) = % % Impact of STS Score on Mortality (ITT) AVR Patients 176 133 122 116 106 94 79 175 119 114 107 96 80 63 STS ≤11 STS 11 0%10%20%30%40%50%60%70%0 6 12 18 24 30 36Mortality Months post Randomization STS 0 11STS 11HR [95% CI] = [, ] p (log rank) = No. at Risk % % % % % % Impact of STS Score on Mortality (ITT) TAVR Patients 177 155 141 128 117 106 87 171 143 120 111 105 81 62 STS ≤11 STS 11 0%10%20%30%40%50%60%70%0 6 12 18 24 30 36Mortality Months post Randomization STS 0 11STS 11HR [95% CI] = [, ] p (log rank) = No. at Risk % % % % % % Conclusions (1) ? At 3 years, in patients with symptomatic severe AS who were highrisk candidates for surgical AVR … – There was no difference in allcause mortality between TAVR and surgery – Baseline predictors of mortality were different for TAVR (. BMI, PVD) and surgery (. STS score, mod/severe MR) – Symptom improvement was similar in both groups and maintained thru three years ? At 3 years, strokes were similar in TAVR and surgery patients, despite increased periprocedural neurologic events in TAVR patients – There was no late (after 30 days) stroke hazard in TAVR pared with surgery Conclusions (2) ? Echocardiographic analysis revealed… – At 3 years, TAVR hemodynamic performance was maintained with similar valve gradients and areas pared with surgery – Both AVR and surgery resulted in significant LVEF improvement and LV mass regression – Postprocedural paravalvular AR was frequent after TAVR (mildmodsevere ~ 50% pts) without important changes during 3 year FU – Even mild postprocedural AR (PVL and total AR) was associated with increased subsequent mortality Implications ? 3year results from the highrisk operable PARTNER cohort indicate… – TAVR should be considered an alternative to surgery with similar mortality and similar other major clinical outes – Periprocedural stroke concerns after TAVR have diminished with longer term followup – TAVR valve hemodynamics have remained stable, although periprocedural regurgitation (even mild) has emerged as a predictor of late mortality ? Future efforts should be directed towards reducing TAVR procedurerelated plications, including strokes, vascular events, and paravalvular regurgitation Thank you PARTNER TEAM 演講完畢，謝謝觀看！
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