バルーンで拡張可能なバルブによるトランスキャテーター大動脈弁の繰り返し置換の結果:登録試験
Raj R Makkar1, Samir Kapadia2, Tarun Chakravarty1
1Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Lancet (London, England)
|September 3, 2023
まとめ
バルーンで膨張可能なバルブを使用したリド・トランスキャテーター大動脈弁置換 (TAVR) は,失敗したTAVRに対して安全で有効です. 死亡率と脳卒中率を含むアウトカムは,マッチした患者の初期TAVR手順に類似した.
科学分野:
- 心血管医学
- 介入心臓科
- 医療機器
背景:
- トランスキャセータ性大動脈弁置換 (TAVR) の使用が増えるにつれて,失敗したTAVRの管理を理解することが必要になります.
- TAVRを繰り返す (再TAVR) は,TAVRの故障の新たな選択肢です.
研究 の 目的:
- バルーンで膨張可能なバルブを使用して,リド-TAVRの安全性と有効性を評価する.
- レド-TAVRとネイティブバルブの初期TAVRを比較する.
主な方法:
- STS/ACC TAVT レジストリ (2011-2022) の患者の分析
- レド-TAVRとネイティブ-TAVRのコホートとの比較は,傾向スコアマッチングを使用しています.
- 処置,心声,および臨床の結果の評価
主要な成果:
- 低処置合併症率は,ネイティブTAVRに似ています.
- 30日または1年の死亡率と脳卒中率は,リドーTAVRとネイティブTAVRの間で有意な差異はありません.
- Redo- TAVRは大動脈弁の傾斜を減少させましたが,1年後にネイティブ- TAVRよりも高いままでした.
結論:
- バルーン拡張バルブによる再TAVRは TAVRの失敗に効果があり,合併症は少ない.
- 結果は,選択された患者の初期 TAVR と比較できます.
- Redo-TAVRは TAVRがうまくいかない場合の合理的な治療法です.
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