Mortality and Stroke
In the present study, the low 1-year mortality rate of 7.4% was
consistent with the 1-year rate of 4.7% in forty-three high-risk
patients from the China Trial9 and a 5.5% mortality
of TA-TAVR procedures in Germany in 201425. The 1-year
mortality rates reported with the J-Valve device are lower than the
first-generation reported in other studies, namely the CoreValve, 31%
in 26 high-risk patients 7 and 21.4% in the other
CoreValve study (n=43)6. Silaschi et al reported
transapical TAVR with higher a 1-year mortality rate (20.1%) than that
the present study 26. The initial German experience
6-month mortality was 19.3% with JeneValve for the treatment of
AR16. Compare to AS, although AR is younger and lower
mean STS score, howerver the mortality was no differences27 . These differences suggest differing
pathophysiology of the larger left ventricle and the lower LVEF after
treatment of AR is quantitatively and qualitatively different from
AS28. Notebly, a recent meta-analysis of AR patients
who underwent TAVR showed that the one-year mortality is
25%24.
The incidence of disabling stroke at 1-year (2.2%) in the present study
was consistent with the 2.3% reported in the China clinical Trial9. At 1-year, stroke was 4.7% in CoreValve experience
and 3.3%7 in JeneValve of the JUPITER registry26, which was slightly higher than the present study.
However, stroke is uncommon in TAVR treatment for AR. Mainly due to a
lack of valve calcification and the simplicity and reliability of the
THV implantation in patients.