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トランスキャセータ性大動脈弁置換後の伝導障害:現在の状態と将来の見通し

Vincent Auffret¹, Rishi Puri¹, Marina Urena¹

¹From University Hospital Pontchaillou, Cardiology and Vascular Disease Department, CIC-IT 804, Rennes 1 University, Signal and Image Processing Laboratory (LTSI), INSERM U1099, France (V.A.); Quebec Heart and Lung Institute, Laval University, Quebec City, Canada (V.A., R.P., C.C., T.R.-G., F.P., J.R.,-C.); and Bichat-Claude Bernard University Hospital, Paris, France (M.U.).

|September 13, 2017

まとめ

トランスキャテーターによる大動脈弁置換 (TAVR) は通常,伝導障害を引き起こし,しばしばペースメーカーが必要になります. リスク要因を理解し,管理戦略を改善することは,TAVR患者のアウトカムにとって極めて重要です.

科学分野:

心臓病科
介入心臓科
医療機器

背景:

トランスキャテーター大動脈弁置換 (TAVR) は,高リスク患者の大動脈狭窄の標準治療法である.
導管障害は,新発症の左ブランクブロックと心房閉塞を含む,TAVRの頻繁な合併症です.
技術の進歩にもかかわらず,これらの伝導の問題の発生率は高いままです.

研究の目的:

TAVR後の伝導障害の発生率,予測要因,および臨床関連性を検討する.
TAVRに関連する伝導合併症の管理戦略を提案する.
TAVRが低リスク集団に拡大するにつれリスク軽減の必要性が高まっています

主な方法:

TAVRに関連する伝導障害に関する既存の証拠のレビュー.
ペースメーカーのインプラントのリスクの増加に関連する要因の特定.
新しく発症した伝導異常の予後効果の分析

主要な成果:

新発症の左ブランクブロックと進んだ心房ブランクブロックは最も一般的な合併症です.
前側の右ブンドルブランクブロック,バルブタイプ,インプラントの深さは重要な危険因子です.
これらの合併症は患者の予後に影響を及ぼします.

結論:

伝導障害は TAVR の後に重要な懸念事項であり,積極的な管理が必要である.
リスクの高い患者を特定し移植技術を最適化することでリスクを軽減できます
効果的な戦略の開発は,TAVR手順の安全な拡張に不可欠です.

キーワード:

心臓発作バンドル・ブランチ・ブロック人工ペースメーカートランスキャテーターによる大動脈弁の置換

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