拡張された多中心の米国メロディバルブ試験におけるトランスキャテーター肺弁の配置後の短期および中期的なアウトカム
Doff B McElhinney1, William E Hellenbrand, Evan M Zahn
1Department of Cardiology, Children's Hospital Boston, Boston, Mass 10032, USA.
Circulation
|July 21, 2010
まとめ
メロディーバルブを用いたトランスキャテーター肺弁置換は,肺吐症の患者の高い処置成功と短期的な機能改善を示しています. 患者の慎重な選択と右心室外流管阻害の管理は,最適な結果を出すために不可欠です.
科学分野:
- 心臓病学 心臓病学
- 介入性心臓病学 介入性心臓病学
- 医療機器 医療機器について
背景:
- トランスキャテーター肺弁の配置は,肺吐および右心室外流管阻害に対する新興の治療法です.
- メロディ・バルブは,機能不全の右心室外流管に使用するために米国で承認されています.
研究 の 目的:
- トランスカテーター肺弁置換のためのメロディ弁の多センター試験の最新結果を報告する.
- 処置の成功,短期的な弁機能,およびメロディー弁の植入に関連する合併症を評価する.
主な方法:
- 5つのセンターで,合計136人の患者が,意図されたメロディー弁の埋め込みのためにキャセテリゼーションを受けた.
- 移植は124人の患者に試みられたが,12人は冠動脈圧縮リスクなどの禁忌のために除外された.
- 処置の成功,弁機能,合併症に関するデータを収集,分析した.
主要な成果:
- 処置の成功率は高く,右心室流出管の傾斜と肺の再発が著しく減少しました.
- 植入後早期の肺吐は,すべての患者で軽度であった.
- メロディ弁の機能不全または再介入からの自由は,1年後に93.5%であった;ステント骨折は14ヶ月で22.2%で発生した.
結論:
- メロディバルブ試験は,高い手順の成功を示し,短期的なバルブ機能を奨励しました.
- 再介入は主に右心室外流管阻害のためであり,患者の選択と阻害管理を強調した.
- ステント骨折の予防と管理は,バルブの長期的な耐久性にとって重要です.
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