Transcatheter aortic valve implantation via different approaches can improve left cardiac structure and function in patients with pure aortic regurgitation

XU Yingying; YANG Dongmei

doi:10.12122/j.issn.1674-4500.2025.08.12

Abstract：Objective To compare the early efficacy of transfemoral transcatheter aortic valve implantation(TF-TAVI)with transapical transcatheter aortic valve implantation(TA-TAVI)in the treatment of pure aortic regurgitation(PAR)based on echocardiography.Methods From January 2021 to November 2024,96 patients with PAR who received treatment at the First Affiliated Hospital of University of Science and Technology of China were retrospectively enrolled.According to the surgical approach,patients were divided into the TF-TAVI group and the TA-TAVI group.The TF-TAVI group had 46 patients,including 22 males and 24 females,with the age of 56-85(72.39±7.40)years old;the TA-TAVI group had 50 patients,with 33 males and 17 females,with the age of 55-85(71.68±8.01)years old.Preoperative clinical data,perioperative data(surgical success rate,surgical duration,Length of hospital stay),echocardiographic parameters before and after surgery,and the incidence of postoperative complications were analyzed to compare the early surgical efficacy between the two groups.Results There were no statistically significant differences in preoperative clinical data between the two groups(P>0.05).The surgery duration and hospital stay in the TF-TAVI group were both shorter than those in the TA-TAVI group(P<0.05).The sizes of the left atrium and ventricle,left ventricular volume,stroke volume,cardiac output,and pulmonary artery systolic pressure in both groups were significantly reduced compared to preoperative values(P<0.05);the left ventricular wall thickness was relatively increased compared to preoperative values(P<0.05);the preoperative and postoperative diameters of the aortic sinus and the preoperative left ventricular end-diastolic diameter(LVIDd)in the TF-TAVI group were smaller than those in the TA-TAVI group(P<0.05);however,there was no statistically significant difference in postoperative LVIDd between the two groups(P>0.05).The incidence of postoperative pericardial effusion in the TF-TAVI group was lower than that in the TA-TAVI group(P<0.05);but,the incidence of postoperative conduction block and the rate of permanent pacemaker implantation were higher in the TF-TAVI group than in the TA-TAVI group(P<0.05).Conclusion Echocardiography can effectively evaluate the structure and function of the left cardiac before and after transcatheter aortic valve implantation(TAVI),and quantitatively analyze the effectiveness of left ventricular reverse remodeling.The efficacy and perioperative safety of TF-TAVI and TA-TAVI in the treatment of pure aortic regurgitation are comparable,both are safe and effective surgical options.