在CoreValve跨导管大动脉植入后永久性起器插入:发生率和促成因素 (英国CoreValve协作)
M Z Khawaja1, R Rajani, A Cook
1UK CoreValve Collaborative, Sussex Cardiac Centre, Brighton & Sussex University Hospital Trust, Eastern Road, Brighton, East Sussex, BN2 5BE, UK.
Circulation
|February 23, 2011
概括
大约三分之一的患者在CoreValve跨导管大动脉植入后需要永久性起器 (PPM). 诸如心脏阻塞和气球预扩张等因素增加了这种风险.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 医疗器械 医疗器械
背景情况:
- 永久性起器 (PPM) 要求是经过过导管大动脉植入 (TAVI) 后的一个已知的并发症.
- 评估CoreValve TAVI后PPM的发生率和预测因素对于患者管理至关重要.
研究的目的:
- 在英国CoreValve植入后30天内确定PPM的发病率.
- 开发一个解剖学和电生理学模型,预测在TAVI之后需要PPM.
主要方法:
- 在英国10个中心对270名接受CoreValve TAVI治疗的患者进行了回顾性分析.
- 评估基线和术后心电图参数,包括QRS持续时间和捆绑分支区块发生率.
- 多变量分析以确定PPM要求的独立预测因素.
主要成果:
- 33.3%的患者在手术后30天内需要PPM.
- 观察到QRS持续时间 (105至135毫秒) 和LBBB发生率 (13%至61%) 显著增加.
- 对PPM的独立预测因素包括周围手术AV阻塞,气球预扩张,更大的假体尺寸,隔膜直径增加和QRS持续时间延长.
结论:
- 三分之一接受CoreValve TAVI的患者需要在30天内进行PPM.
- 周围程序性AV阻塞,气球预扩张,更大的假体,增加的腹腔间隔膜直径和延长的QRS持续时间与PPM需求有关.
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