跨导管大动脉植入:对临床和门相关结果的影响
John G Webb1, Lukas Altwegg, Robert H Boone
1St. Paul's Hospital, 1081 Burrard St, Vancouver, BC V6Z 1Y6, Canada. webb@providencehealth.bc.ca
Circulation
|June 3, 2009
概括
跨导管大动脉植入为高风险大动脉狭窄患者提供功能改善. 长期的结果更多地取决于并发症,而不是门手术本身.
科学领域:
- 心血管医学 心血管医学
- 干预心脏病学 干预心脏病学
- 心脏外科手术 心脏外科手术
背景情况:
- 过导管大动脉植入 (TAVI) 是对大动脉狭窄的开放心脏手术的替代方案.
- 对于程序式TAVI方法的长期数据有限.
研究的目的:
- 评估通过导管对大动脉植入的程序方法的结果.
- 评估接受TAVI治疗的高风险患者的功能改善和生存率.
主要方法:
- 在168名患有严重大动脉狭窄和高手术风险的患者中进行了TAVI.
- 接入路线包括跨动脉 (n=113) 和跨脉 (n=55).
- 结果被评估到1年后的程序,与一些后续延长超过3年.
主要成果:
- 总体成功率为94.1%,程序内死亡率低 (1.2%).
- 一年生存率为74%,随着时间的推移,死亡率下降.
- 功能类在1年内显著改善 (P<0.001).
- 准膜反是常见的,但轻度和稳定;没有观察到结构的故障.
结论:
- 在高风险的大动脉狭窄患者中,TAVI提供了早期和持续的功能改善.
- 晚期结果主要受到并发症的影响,而不是TAVI手术或门.
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