Short-term results of transcatheter aortic valve replacement using Venus A-Plus valve delivery system in patients with severe aortic stenosis: A retrospective cohort study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHANG Hang , WANG Huajun , SHI Fengwu , LIU Su , MA Qianli ,  AN Jinghui

Department of Cardiac Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, P. R. China;

Corresponding?author：

AN Jinghui, Email: Anjinghui2009@126.com

Keywords：

Severe aortic stenosis; transcatheter aortic valve replacement; Venus A-Plus; bicuspid aortic valve; Venus A; valve delivery system; perivalvular leak; safety

DOI：

10.7507/1007-4848.202402037

Video：

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Objective To evaluate the short-term efficacy of transcatheter aortic valve replacement (TAVR) using Venus A-Plus valve delivery system in patients with severe aortic stenosis. Methods The clinical data of patients undergoing TAVR in our hospital from August 2018 to March 2022 were collected and they were divided into a Venus A-Plus and a Venus A group according to the type of valve delivery system used. The perioperative data of the two groups were compared. Results A total of 121 patients were included, including 70 patients in the Venus A-Plus group [45 males and 25 females with a mean age of (67.81±6.62) years], and 51 patients in the Venus A group [33 males and 18 females with a mean age of (68.25±7.01) years]. All patients underwent TAVR, and the postoperative hemodynamic features (left ventricular ejection fraction, mean cross-valve pressure difference, peak flow rate) were significantly improved (P<0.05). There was no statistical difference in surgical success rate, all-cause mortality, conversion to thorax opening, valve-in-valve placement, moderate or above perivalvular regurgitation, new left bundle branch block or new right bundle branch block between the two groups (P>0.05). Conclusion TAVR with Venus A-Plus valve delivery system in patients with severe aortic stenosis shows comparable efficacy to the first-generation Venus A system and is satisfactory, safe and reliable.

Citation： ZHANG Hang, WANG Huajun, SHI Fengwu, LIU Su, MA Qianli, AN Jinghui. Short-term results of transcatheter aortic valve replacement using Venus A-Plus valve delivery system in patients with severe aortic stenosis: A retrospective cohort study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2026, 33(3): 438-443. doi: 10.7507/1007-4848.202402037 Copy

1.	Vahanian A, Beyersdorf F, Praz F, et al. 2021 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J, 2022, 43(7): 561-632.
2.	中國醫師協會心血管內科醫師分會結構性心臟病學組, 亞太結構性心臟病俱樂部. 中國經導管主動脈瓣置換術臨床路徑專家共識(2024版). 中國介入心臟病學雜志, 2024, 32(11): 601-617.Cardiology Committee of Cardiovascular Physicians Branch, Chinese Medical Doctor Association, Asia Pacific Structural Heart Disease Club. 2024 expert consensus on clinical pathway for transcatheter aortic valve replacement in China. Chin J Interv Cardiol, 2024, 32(11): 601-617.
3.	洪楠超, 潘文志, 劉先寶. 心臟瓣膜病介入中心年度報告 (2024). 中國介入心臟病學雜志, 2025, 33(11): 614-619.Hong NC, Pan WZ, Liu XB. Quality control report of Heart Valve Center in 2024. Chin J Interv Cardiol, 2025, 33(11): 614-619.
4.	國家放射與治療臨床醫學研究中心, 蘇州工業園區東方華夏心血管健康研究院. 經導管主動脈瓣置換術中國專家共識 (2025版). 中國介入心臟病學雜志, 2025, 33(12): 661-674.National Clinical Research Center for Interventional Medicine, China Heart House. Chinese expert consensus on transcatheter aortic valve replacement (2025). Chin J Interv Cardiol, 2025, 33(12): 661-674.
5.	李亮, 潘廣瑞, 房玲. 自膨式Venus-A瓣膜與國產Renatus球囊擴張式介入瓣膜治療重度主動脈瓣狹窄的臨床效果比較. 中國醫藥, 2025, 20(3): 337-341.Li L, Pan GR, Fang L. Comparison of the clinical effect of self-expanding Venus-A valve and domestic Renatus balloon expandable interventional valve in the treatment of severe aortic stenosis. China Pharm, 2025, 20(3): 337-341.
6.	王墨揚, 周政, 陶凌, 等. 真實世界二葉式主動脈瓣重度狹窄患者應用Venus-A瓣膜行經導管主動脈瓣置換術的多中心經驗. 中國循環雜志, 2022, 37(4): 329-334.Wang MY, Zhou Z, Tao L, et al. Transcatheter aortic valve replacement with self-expanding Venus-A valve in severe aortic stenosis patients with bicuspid aortic valves: experience from multi-center real-world data. Chin Circ J, 2022, 37(4): 329-334.
7.	Liu XB, He YX, Liu CH, et al. First-in-man implantation of the retrievable and repositionable VenusA-Plus valve. World J Emerg Med, 2018, 9(1): 64-66.
8.	Cribier A, Eltchaninoff H, Bash A, et al. Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: first human case description. Circulation, 2002, 106(24): 3006-3008.
9.	張蔚菁, 潘文志, 管麗華, 等. 經導管主動脈瓣置換術(TAVR)中同期行瓣中瓣置入術的單中心一年期臨床隨訪結果. 中國胸心血管外科臨床雜志, 2021, 28(8): 888-894.Zhang WJ, Pan WZ, Guan LH, et al. The 1-year follow-up results of intraprocedural valve-in-valve deployment for treatment of aortic regurgitation following transcatheter aortic valve replacement (TAVR) in a single center. Chin J Thorac Cardiovasc Surg, 2021, 28(8): 888-894.
10.	Cribier A. The development of transcatheter aortic valve replacement (TAVR). Glob Cardiol Sci Pract, 2016, 2016(4): e201632.
11.	Han Y. Current clinical data and experience of TAVR in China. Eur Heart J, 2022, 43(22): 2087-2088.
12.	Gaede L, Blumenstein J, Husser O, et al. Aortic valve replacement in Germany in 2019. Clin Res Cardiol, 2021, 110(3): 460-465.
13.	Carroll JD, Mack MJ, Vemulapalli S, et al. STS-ACC TVT registry of transcatheter aortic valve replacement. J Am Coll Cardiol, 2020, 76(21): 2492-2516.
14.	孔祥權, 高曉飛, 張娟, 等. 經導管主動脈瓣置換術相關新瓣膜的研究進展. 華西醫學, 2023, 38(9): 1309-1313.Kong XQ, Gao XF, Zhang J, et al. Research progress of transcatheter aortic valve replacement-related new valve prostheses. West China Med J, 2023, 38(9): 1309-1313.
15.	宋聰慧, 程帥, 張申偉. 超聲引導下Venus A-Plus可回收瓣膜輸送系統聯合TAVR治療二葉式主動脈瓣狹窄的療效觀察. 中西醫結合心腦血管病雜志, 2023, 21(20): 3814-3817.Song CH, Cheng S, Zhang SW. Observation on the efficacy of the ultrasound-guided Venus A-Plus retrievable valve delivery system combined with TAVR in the treatment of bicuspid aortic stenosis. J Integr Tradit Chin West Med Cardiovasc Cerebrovasc Dis, 2023, 21(20): 3814-3817.
16.	洪景宣, 郭延松, 陳新敬, 等. 單中心經導管主動脈瓣置換術學習曲線分析. 中國循環雜志, 2024, 39(1): 68-74.Hong JX, Guo YS, Chen XJ, et al. Single-center learning curve analysis of transcatheter aortic valve replacement. Chin Circ J, 2024, 39(1): 68-74.
17.	Nishimura RA, Otto CM, Bonow RO, et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol, 2014, 63(22): e57-185.
18.	Mack MJ, Leon MB, Smith CR, et al. 5-year outcomes of transcatheter aortic valve replacement or surgical aortic valve replacement for high surgical risk patients with aortic stenosis (PARTNER 1): a randomised controlled trial. Lancet, 2015, 385(9986): 2477-2484.
19.	Herrmann HC, Thourani VH, Kodali SK, et al. One-year clinical outcomes with SAPIEN 3 transcatheter aortic valve replacement in high-risk and inoperable patients with severe aortic stenosis. Circulation, 2016, 134(2): 130-140.
20.	Adams DH, Popma JJ, Reardon MJ, et al. Transcatheter aortic-valve replacement with a self-expanding prosthesis. N Engl J Med, 2014, 370(19): 1790-1798.
21.	Reardon MJ, Van Mieghem NM, Popma JJ, et al. Surgical or transcatheter aortic-valve replacement in intermediate-risk patients. N Engl J Med, 2017, 376(14): 1321-1331.
22.	段維程, 李華, 李亞雄, 等. 二葉式主動脈瓣狹窄患者行經導管主動脈瓣置換術與外科主動脈瓣置換術治療的早期臨床療效對比分析. 中國心血管雜志, 2025, 30(3): 263-269.Duan WC, Li H, Li YX, et al. Early efficacy analysis of transcatheter aortic valve replacement and surgical aortic valve replacement in patients with aortic stenosis caused by bicuspid malformation. Chin J Cardiovasc Med, 2025, 30(3): 263-269.
23.	馬云龍, 吳岳, 袁祖貽, 等. 自膨脹式經導管主動脈瓣置換術瓣膜的優勢及相關研究進展. 華西醫學, 2023, 38(12): 1914-1919.Ma YL, Wu Y, Yuan ZY, et al. Advantages and related developments of self-expandable valves for transcatheter aortic valve replacement. West China Med J, 2023, 38(12): 1914-1919.
24.	Xiong TY, Ali WB, Feng Y, et al. Transcatheter aortic valve implantation in patients with bicuspid valve morphology: a roadmap towards standardization. Nat Rev Cardiol, 2023, 20(1): 52-67.
25.	Xu P, Dong S, Wu L, et al. Maternal and placental DNA methylation changes associated with the pathogenesis of gestational diabetes mellitus. Nutrients, 2022, 15(1): 70.
26.	Laltlanzovi C, Choudhury M, Singh R, et al. Study of serum adiponectin and interleukin-1β levels in women with gestational diabetes. Indian J Endocrinol Metab, 2022, 26(6): 581-588.
27.	張航, 王華君, 石鳳梧, 等. 3D打印技術在經導管主動脈瓣置換術治療二葉式主動脈瓣狹窄中的應用. 中國醫科大學學報, 2025, 54(10): 942-945, 957.Zhang H, Wang HJ, Shi FW, et al. Application of 3D printing technology in transcatheter aortic valve replacement for bicuspid aortic stenosis. J China Med Univ, 2025, 54(10): 942-945, 957.
28.	Hong N, Pan W, Liu X, et al. Transcatheter aortic valve replacement for bicuspid vs. tricuspid aortic stenosis among patients at low surgical risk in China: from the multicenter national NTCVR database. J Clin Med, 2023, 12(1): 387.

1. Vahanian A, Beyersdorf F, Praz F, et al. 2021 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J, 2022, 43(7): 561-632.
2. 中國醫師協會心血管內科醫師分會結構性心臟病學組, 亞太結構性心臟病俱樂部. 中國經導管主動脈瓣置換術臨床路徑專家共識(2024版). 中國介入心臟病學雜志, 2024, 32(11): 601-617.Cardiology Committee of Cardiovascular Physicians Branch, Chinese Medical Doctor Association, Asia Pacific Structural Heart Disease Club. 2024 expert consensus on clinical pathway for transcatheter aortic valve replacement in China. Chin J Interv Cardiol, 2024, 32(11): 601-617.
3. 洪楠超, 潘文志, 劉先寶. 心臟瓣膜病介入中心年度報告 (2024). 中國介入心臟病學雜志, 2025, 33(11): 614-619.Hong NC, Pan WZ, Liu XB. Quality control report of Heart Valve Center in 2024. Chin J Interv Cardiol, 2025, 33(11): 614-619.
4. 國家放射與治療臨床醫學研究中心, 蘇州工業園區東方華夏心血管健康研究院. 經導管主動脈瓣置換術中國專家共識 (2025版). 中國介入心臟病學雜志, 2025, 33(12): 661-674.National Clinical Research Center for Interventional Medicine, China Heart House. Chinese expert consensus on transcatheter aortic valve replacement (2025). Chin J Interv Cardiol, 2025, 33(12): 661-674.
5. 李亮, 潘廣瑞, 房玲. 自膨式Venus-A瓣膜與國產Renatus球囊擴張式介入瓣膜治療重度主動脈瓣狹窄的臨床效果比較. 中國醫藥, 2025, 20(3): 337-341.Li L, Pan GR, Fang L. Comparison of the clinical effect of self-expanding Venus-A valve and domestic Renatus balloon expandable interventional valve in the treatment of severe aortic stenosis. China Pharm, 2025, 20(3): 337-341.
6. 王墨揚, 周政, 陶凌, 等. 真實世界二葉式主動脈瓣重度狹窄患者應用Venus-A瓣膜行經導管主動脈瓣置換術的多中心經驗. 中國循環雜志, 2022, 37(4): 329-334.Wang MY, Zhou Z, Tao L, et al. Transcatheter aortic valve replacement with self-expanding Venus-A valve in severe aortic stenosis patients with bicuspid aortic valves: experience from multi-center real-world data. Chin Circ J, 2022, 37(4): 329-334.
7. Liu XB, He YX, Liu CH, et al. First-in-man implantation of the retrievable and repositionable VenusA-Plus valve. World J Emerg Med, 2018, 9(1): 64-66.
8. Cribier A, Eltchaninoff H, Bash A, et al. Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: first human case description. Circulation, 2002, 106(24): 3006-3008.
9. 張蔚菁, 潘文志, 管麗華, 等. 經導管主動脈瓣置換術(TAVR)中同期行瓣中瓣置入術的單中心一年期臨床隨訪結果. 中國胸心血管外科臨床雜志, 2021, 28(8): 888-894.Zhang WJ, Pan WZ, Guan LH, et al. The 1-year follow-up results of intraprocedural valve-in-valve deployment for treatment of aortic regurgitation following transcatheter aortic valve replacement (TAVR) in a single center. Chin J Thorac Cardiovasc Surg, 2021, 28(8): 888-894.
10. Cribier A. The development of transcatheter aortic valve replacement (TAVR). Glob Cardiol Sci Pract, 2016, 2016(4): e201632.
11. Han Y. Current clinical data and experience of TAVR in China. Eur Heart J, 2022, 43(22): 2087-2088.
12. Gaede L, Blumenstein J, Husser O, et al. Aortic valve replacement in Germany in 2019. Clin Res Cardiol, 2021, 110(3): 460-465.
13. Carroll JD, Mack MJ, Vemulapalli S, et al. STS-ACC TVT registry of transcatheter aortic valve replacement. J Am Coll Cardiol, 2020, 76(21): 2492-2516.
14. 孔祥權, 高曉飛, 張娟, 等. 經導管主動脈瓣置換術相關新瓣膜的研究進展. 華西醫學, 2023, 38(9): 1309-1313.Kong XQ, Gao XF, Zhang J, et al. Research progress of transcatheter aortic valve replacement-related new valve prostheses. West China Med J, 2023, 38(9): 1309-1313.
15. 宋聰慧, 程帥, 張申偉. 超聲引導下Venus A-Plus可回收瓣膜輸送系統聯合TAVR治療二葉式主動脈瓣狹窄的療效觀察. 中西醫結合心腦血管病雜志, 2023, 21(20): 3814-3817.Song CH, Cheng S, Zhang SW. Observation on the efficacy of the ultrasound-guided Venus A-Plus retrievable valve delivery system combined with TAVR in the treatment of bicuspid aortic stenosis. J Integr Tradit Chin West Med Cardiovasc Cerebrovasc Dis, 2023, 21(20): 3814-3817.
16. 洪景宣, 郭延松, 陳新敬, 等. 單中心經導管主動脈瓣置換術學習曲線分析. 中國循環雜志, 2024, 39(1): 68-74.Hong JX, Guo YS, Chen XJ, et al. Single-center learning curve analysis of transcatheter aortic valve replacement. Chin Circ J, 2024, 39(1): 68-74.
17. Nishimura RA, Otto CM, Bonow RO, et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol, 2014, 63(22): e57-185.
18. Mack MJ, Leon MB, Smith CR, et al. 5-year outcomes of transcatheter aortic valve replacement or surgical aortic valve replacement for high surgical risk patients with aortic stenosis (PARTNER 1): a randomised controlled trial. Lancet, 2015, 385(9986): 2477-2484.
19. Herrmann HC, Thourani VH, Kodali SK, et al. One-year clinical outcomes with SAPIEN 3 transcatheter aortic valve replacement in high-risk and inoperable patients with severe aortic stenosis. Circulation, 2016, 134(2): 130-140.
20. Adams DH, Popma JJ, Reardon MJ, et al. Transcatheter aortic-valve replacement with a self-expanding prosthesis. N Engl J Med, 2014, 370(19): 1790-1798.
21. Reardon MJ, Van Mieghem NM, Popma JJ, et al. Surgical or transcatheter aortic-valve replacement in intermediate-risk patients. N Engl J Med, 2017, 376(14): 1321-1331.
22. 段維程, 李華, 李亞雄, 等. 二葉式主動脈瓣狹窄患者行經導管主動脈瓣置換術與外科主動脈瓣置換術治療的早期臨床療效對比分析. 中國心血管雜志, 2025, 30(3): 263-269.Duan WC, Li H, Li YX, et al. Early efficacy analysis of transcatheter aortic valve replacement and surgical aortic valve replacement in patients with aortic stenosis caused by bicuspid malformation. Chin J Cardiovasc Med, 2025, 30(3): 263-269.
23. 馬云龍, 吳岳, 袁祖貽, 等. 自膨脹式經導管主動脈瓣置換術瓣膜的優勢及相關研究進展. 華西醫學, 2023, 38(12): 1914-1919.Ma YL, Wu Y, Yuan ZY, et al. Advantages and related developments of self-expandable valves for transcatheter aortic valve replacement. West China Med J, 2023, 38(12): 1914-1919.
24. Xiong TY, Ali WB, Feng Y, et al. Transcatheter aortic valve implantation in patients with bicuspid valve morphology: a roadmap towards standardization. Nat Rev Cardiol, 2023, 20(1): 52-67.
25. Xu P, Dong S, Wu L, et al. Maternal and placental DNA methylation changes associated with the pathogenesis of gestational diabetes mellitus. Nutrients, 2022, 15(1): 70.
26. Laltlanzovi C, Choudhury M, Singh R, et al. Study of serum adiponectin and interleukin-1β levels in women with gestational diabetes. Indian J Endocrinol Metab, 2022, 26(6): 581-588.
27. 張航, 王華君, 石鳳梧, 等. 3D打印技術在經導管主動脈瓣置換術治療二葉式主動脈瓣狹窄中的應用. 中國醫科大學學報, 2025, 54(10): 942-945, 957.Zhang H, Wang HJ, Shi FW, et al. Application of 3D printing technology in transcatheter aortic valve replacement for bicuspid aortic stenosis. J China Med Univ, 2025, 54(10): 942-945, 957.
28. Hong N, Pan W, Liu X, et al. Transcatheter aortic valve replacement for bicuspid vs. tricuspid aortic stenosis among patients at low surgical risk in China: from the multicenter national NTCVR database. J Clin Med, 2023, 12(1): 387.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Short-term results of transcatheter aortic valve replacement using Venus A-Plus valve delivery system in patients with severe aortic stenosis: A retrospective cohort study

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