Five- Year Outcomes in Low-Risk Patients Undergoing Surgery in the PARTNER 3 Trial.

• Tác giả: Guido Ascione, Vasilis Babaliaros, Philipp Blanke, Sarah Clarke, David J Cohen, Philippe Genereux, Marissa Gunnarsson, Robert Guyton, Rebecca T Hahn, Howard C Herrmann, Samir R Kapadia, Susheel K Kodali, Jonathon Leipsic, Martin B Leon, Michael J Mack, Mahesh V Madhavan, Raj Makkar, S Chris Malaisrie, Brandon Park, Philippe Pibarot, Mark J Russo, Craig R Smith, Molly Szerlip, Wilson Y Szeto, Julien Ternacle, Vinod H Thourani, John G Webb
• Ngôn ngữ: eng
• Ký hiệu phân loại: 150.1984 Philosophy and theory
• Thông tin xuất bản: Netherlands : The Annals of thoracic surgery , 2025
• Bộ sưu tập: NCBI
• ID: 217431

Tóm tắt

 BACKGROUND: Surgery remains an important treatment for low-risk patients with severe symptomatic aortic stenosis (AS). This study evaluated 5-year outcomes in low-risk patients undergoing isolated surgical aortic valve replacement (SAVR) or SAVR with concomitant procedures within the randomized Placement of Aortic Transcatheter Valves (PARTNER) 3 trial. METHODS: In the PARTNER 3 trial, 454 patients underwent surgery for severe, symptomatic, trileaflet AS and were followed up for 5 years. Patients were stratified into those undergoing isolated SAVR (n = 334
  73.6%) vs concomitant SAVR (n = 120
  26.4%). Short- and long-term morbidity was adjudicated by a Clinical Events Committee. Hemodynamic valve performance was evaluated by an echocardiographic core laboratory. Patient-reported health status was measured with the Kansas City Cardiomyopathy Questionnaire (KCCQ). RESULTS: The mean age of participants was 73.6 ± 6.1 years
  71.1% of these patients were male. The median SAVR implant size was 23 mm overall. Five-year all-cause mortality (with vital status sweep) was 9.0% for all patients (8.5% isolated SAVR
  10.2% concomitant SAVR
  P = .58), comparable to a recent analysis of low-risk isolated SAVR-treated patients in the STS database (overall mortality, 7.1%). The average 5-year mean gradient was 11.7 ± 5.6 mm Hg overall. Reintervention rates were low in both groups (isolated SAVR, 2.3% vs concomitant SAVR, 5.0%
  P = .21), and most patients (isolated SAVR, 87.9%
  concomitant SAVR, 86.1%) were alive with no evidence of bioprosthetic valve failure at 5 years. CONCLUSIONS: SAVR in low-risk patients in the PARTNER 3 trial demonstrated excellent 5-year outcomes. Five-year mortality was similar in patients undergoing isolated SAVR vs concomitant SAVR. This result was comparable to recently published national SAVR outcomes, thus demonstrating the generalizability of these findings.