https://scholars.lib.ntu.edu.tw/handle/123456789/592587
標題: | Frequency and Significance of Intravascular Hemolysis Before and After Transcatheter Aortic Valve Implantation in Patients With Severe Aortic Stenosis | 作者: | Tsung-Yu Ko MAO-SHIN LIN Lin, Lung-Chun Liu, Ying-Ju CHIH-FAN YEH CHING-CHANG HUANG YING-HSIEN CHEN YIH-SHARNG CHEN HSIEN-LI KAO |
關鍵字: | HIGH-RISK PATIENTS; REPLACEMENT; PROSTHESIS; OUTCOMES; PERFORMANCE; ANEMIA | 公開日期: | 1-一月-2018 | 出版社: | EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC | 卷: | 121 | 期: | 1 | 起(迄)頁: | 69 | 來源出版物: | The American journal of cardiology | 摘要: | Intravascular hemolysis (IVH) has been identified in patients with surgical prosthetic valves, but few have been reported after transcatheter aortic valve implantation (TAVI). We conducted a prospective analysis of 64 TAVI patients. The hemolysis profiles were collected at baseline and 6 months after TAVI. The echocardiography was performed at baseline and 6 months after TAVI. There are 14 patients (21.9%) with IVH before and 24(37.5%) after TAVI. The serum haptoglobin values before and 6 months after TAVI are 126.7 ± 75.1 vs 86.3 ± 57.1 mg/dl (p < 0.001). More ≥moderate paravalvular leakage (PVL) (50% vs 7.5%, p < 0.001), bicuspid aortic valve (BAV) (33.3% vs 5.0%, p = 0.004), use of 23 mm prosthesis (29.2% vs 7.5%, p = 0.03), higher residual valvular pressure gradient (17.9 ± 6.8 mm Hg vs 14.7 ± 5.7 mm Hg, p = 0.05), and lower effective orifice area index (1.05 ± 0.21 vs 1.21 ± 0.29, p = 0.03) were observed in patients with post-TAVI IVH. On multivariate regression analysis, BAV and ≥moderate PVL are independently related to post-TAVI IVH. With log-rank test, 1-year rates of readmission due to cardiovascular cause were significantly higher in patients with post-TAVI IVH (odds ratio 4.5; 95% confidence interval 1.3 to 15.6; p = 0.02), after adjusting age and gender. In conclusion, ≥moderate PVL and BAV are predictors of post-TAVI IVH, which is associated with increased cardiovascular readmission in 1-year follow-up. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/592587 | ISSN: | 00029149 | DOI: | 10.1016/j.amjcard.2017.09.023 | SDG/關鍵字: | haptoglobin; haptoglobin; HP protein, human; adult; aged; aortic stenosis; Article; bicuspid aortic valve; cardiovascular disease; echocardiography; effective orifice area index; female; hemodynamic parameters; hospital readmission; human; intravascular hemolysis; major clinical study; male; mortality; paravalvular leak; priority journal; prosthesis size; residual valvular pressure gradient; transcatheter aortic valve implantation; aortic valve stenosis; blood; cohort analysis; complication; hemolysis; metabolism; middle aged; postoperative complication; prospective study; treatment outcome; very elderly; Aged; Aged, 80 and over; Aortic Valve Stenosis; Cohort Studies; Female; Haptoglobins; Hemolysis; Humans; Male; Middle Aged; Patient Readmission; Postoperative Complications; Prospective Studies; Transcatheter Aortic Valve Replacement; Treatment Outcome |
顯示於: | 醫學系 |
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