没有支架的门是否优于现代支架的门? 一个潜在的随机试验
Ayyaz Ali1, James C Halstead, Fay Cafferty
1Department of Cardiothoracic Surgery, Papworth Hospital, Papworth Everard, Cambridge, CB3 8RE, UK.
Circulation
|July 6, 2006
概括
无支架的大动脉生物假体显示类似的血液动力学性能和左心室质量回归与支架门相比,大动脉门更换后的一年. 然而,无支架门可能会改善心室功能受损的患者的喷射率.
科学领域:
- 心血管外科心血管外科
- 生物医学工程 生物医学工程
- 心脏生理学 心脏生理学
背景情况:
- 假定无支架的大动脉生物假体在血液动力学上优于支架设计.
- 在潜在的随机对照试验中需要进行直接比较.
研究的目的:
- 在无支架和支架的大动脉生物假体之间比较血液动力学性能和左心室质量回归.
- 评估在接受主动脉置换的患者的功能结果.
主要方法:
- 预期随机对照试验比较CE-E Perimount支架与Prima Plus无支架生物假体在161名严重主动脉狭窄的患者中.
- 使用心声学和MRI评估左心室质量回归.
- 测量跨膜梯度以评估血液动力学性能.
主要成果:
- 一年后,在无支架和支架的生物假体之间,左心室质量回归没有显著差异.
- 在两组中都观察到类似的血液动力学性能,具有可比的跨膜梯度.
- 在没有支架接收者和先前存在的心室损伤中观察到的左心室喷射率的显著更大改善.
结论:
- 既有支架的,也没有支架的生物假体在大动脉置换后的一年内提供了出色的临床和血液动力学结果.
- 第二代支架性心周假体实现了可比的血液动力学和左心室质量回归到无支架门.
- 在患有心室功能障碍的患者中,无牙的生物假体可以增强手术后的左心室功能恢复.
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