Application of Mechanical Circulatory Support in Transcatheter Aortic Valve Replacement

WANG Yiwei; ZHAI Mengen; MAO Yu; LIU Yuanzhang; XU Chennian; YANG Chen; JIN Ping; YANG Jian; LIU Yang

doi:10.13498/j.cnki.chin.j.ecls.2025.06.01

Abstract：Objective To compare time-related clinical outcomes between patients undergoing transcatheter aortic valve replacement(TAVR)with prophylactic mechanical circulatory support(pMCS)and emergency mechanical circulatory support(eMCS).Methods Patients who underwent TAVR with MCS at the department of cardiovascular surgery,First Affiliated Hos-pital of Air Force Medical University,between January 2020 and November 2023 were retrospectively included.Patients were divided into pMCS and eMCS groups,based on the MCS strategy.Perioperative and follow-up data were compared between the two groups.The primary endpoints were all-cause mortality within 30 days postoperatively,mortality from day 31 to 1 year,and all-cause mortality within 1 year postoperatively.Results A total of 83 patients were enrolled(pMCS group:n=59;eMCS group:n=24)..Preoperative NYHA functional class was Ⅲ/Ⅳ in both groups,and there was a significant improvement in car-diac function compared to baseline at 30 days and 1 year postoperatively(P<0.001).Compared to the eMCS group,the pMCS group demonstrated superior outcomes in the following:30-day mortality(1.7%vs.25.0%,P<0.001),mortality from 31-day to 1 year(5.2%vs.22.2%,P<0.001),all-cause mortality within 1 year(6.8%vs.41.7%,P<0.001),cardiovascular mortality(5.2%vs.29.2%,P<0.001),and rehospitalization for heart failure(10.3%vs.47.2%,P<0.001)were significantly lower in the pMCS group compared to the eMCS group(all P<0.001).Conclusion Both pMCS and eMCS can be utilized to stabilize hemody-namics and improve prognosis and cardiac function in TAVR patients experiencing circulatory instability.However,pMCS was associated with significantly better clinical outcomes compared to eMCS.