高リスクの患者におけるトランスキャテーター大動脈弁置換後の5年間の臨床結果と弁の耐久性
Romain Didier1, Hélène Eltchaninoff2, Patrick Donzeau-Gouge3
1Department of Cardiology, Brest University Hospital, France (R.D., M.G.).
Circulation
|December 21, 2018
まとめ
トランスキャセータによる大動脈弁置換は,高リスクの患者で最大5年間持続する有効性を示しています. 移植後の臨床的イベントは低かったが,構造弁の悪化率は管理可能であった.
科学分野:
- 心臓病科
- 介入心臓科
- 医療機器
背景:
- 以前,FRANCE-2登録では,トランスキャテータ大動脈弁置換 (TAVR) の早期および中期的な有効性を実証しました.
- この研究では,FRANCE-2のレジスタリから得られた5年間の追跡結果が示されています.
研究 の 目的:
- 5年後のTAVRの長期的臨床およびエコーカルディオグラフィの評価.
- 死亡率,臨床イベント,およびTAVR後の構造弁の悪化 (SVD) を評価する.
主な方法:
- フランスで重度の大動脈狭窄症の TAVR を受けた患者さんの分析.
- 標準的な追跡は30日,6ヶ月,毎年最大5年です.
- バルブ学術研究コンソーシアムの基準で定義された臨床イベント;欧州のコンセンサスによってSVD.
主要な成果:
- 4201人の患者の95. 5%で5年間の生命状態が確認され,全原因死亡率は60. 8%であった.
- ほとんどの心血管疾患は最初の1ヶ月以内に発生し,1年後に心不全の発生率は年間5%未満に減少しました.
- 5年間の重症および中度/重症SVDの割合はそれぞれ2. 5%,13. 3%であった.重症SVDの死亡率は有意に異なる.
結論:
- FRANCE-2登録は,高リスク集団におけるTAVRに関する5年間の最大のデータセットを提供します.
- 1年後の臨床イベントとSVDの低い割合は,両方の義肢タイプに対するTAVRの長期的な有効性を支持する.
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