Hiệu quả dài hạn của TAVI trong điều trị hẹp van động mạch chủ nặng trên dân số Việt Nam: Tử vong sau 5 năm - kết quả và kinh nghiệm tại một trung tâm=Long - term outcomes of TAVI in severe aortic stenosis among a Vietnamese population: 5 - year mortality - results and experience from a single center

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Tác giả: Thị Thùy Lã, Đức Công Nguyễn, Minh Châu Nguyễn, Quốc Khoa Nguyễn, Văn Dương Nguyễn, Văn Tân Nguyễn, Ngọc Dung Phạm, Ngọc Thanh Phan, Hồng Nhật Trần, Thành Nhân Võ

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.235-242

Bộ sưu tập: Metadata

ID: 243627

Thêm vào giỏ

Nghiên cứu nhằm đánh giá hiệu quả dài hạn của phương pháp cấy van động mạch chủ qua ống thông (TAVI) trong điều trị hẹp van động mạch chủ (ĐMC) nặng trên dân số Việt Nam, với kết quả chính là tỉ lệ tử vong tới thời điểm 5 năm. Đối tượng và phương pháp: Nghiên cứu bao gồm 120 bệnh nhân hẹp van ĐMC nặng có triệu chứng được điều trị bằng TAVI tại Bệnh viện Vinmec Central Park Thành phố Hồ Chí Minh từ tháng 3/2017 đến tháng 6/2024. Các đặc điểm lâm sàng, hình ảnh học, thủ thuật và kết quả chính được đánh giá theo tiêu chí VARC-2. Tử vong do mọi nguyên nhân và tử vong do tim mạch được ghi nhận đến 5 năm sau thủ thuật. Kết quả: Tuổi trung bình của bệnh nhân là 74,4 ± 9,4 tuổi, với điểm nguy cơ phẫu thuật STS trung bình 5,8 ± 1,1%. Phần lớn bệnh nhân có mức NYHA III-IV (76,7%) và van ĐMC 2 mảnh chiếm 47,9%. Đường tiếp cận qua động mạch đùi được sử dụng cho 96,7% bệnh nhân, với 89,3% sử dụng van tự bung thế hệ mới Evolut R/Evolut Pro, và kích cỡ van 29mm được sử dụng phổ biến nhất (44,3%). Thành công thủ thuật theo VARC-2 đạt 95,0% (114 bệnh nhân). Trong số 65 bệnh nhân theo dõi đủ 5 năm, tỉ lệ tử vong do mọi nguyên nhân và tử vong do tim mạch lần lượt là 20,0% (13 bệnh nhân) và 12,3% (8 bệnh nhân). Kết luận: Nghiên cứu cho thấy TAVI trong điều trị hẹp van ĐMC nặng trên dân số Việt Nam có kết quả dài hạn khả quan, với tỉ lệ tử vong do mọi nguyên nhân và tử vong do tim mạch sau 5 năm tương đối thấp.This study aimed to evaluate the long-term efficacy of transcatheter aortic valve implantation (TAVI) in treating severe aortic stenosis (AS) in the Vietnamese population. The primary outcome was the mortality rate up to 5 years post-procedure. Methods: The study included 120 symptomatic severe AS patients who underwent TAVI at Vinmec Central Park Hospital, Ho Chi Minh City, from March 2017 to June 2024. Clinical characteristics, imaging data, procedural details, and primary outcomes were assessed according to VARC-2 criteria. All-cause mortality and cardiovascular mortality were recorded up to 5 years post-TAVI. Results: The mean age of the patients was 74.4 ± 9.4 years, with an average STS surgical risk score of 5.8 ± 1.1%. Most patients were classified as NYHA III-IV (76.7%), and 47.9% had bicuspid aortic valves. The transfemoral approach was used in 96.7% of the patients, with 89.3% receiving the self-expanding Evolut R/Evolut Pro valve, and the 29mm valve size was the most commonly used (44.3%). According to VARC-2, device success was achieved in 95.0% (114 patients). Among the 65 patients with a follow-up of at least 5 years, the all-cause mortality rate was 20.0% (13 patients), and the cardiovascular mortality rate was 12.3% (8 patients). Conclusion: The study demonstrates favorable long - term outcomes of TAVI in treating severe AS in the Vietnamese population, with relatively low all-cause and cardiovascular mortality rates at 5 years.

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