在用CoreValve Revalving System植入过导管大动脉后,持续的左捆分支阻塞的临床影响
Luca Testa1, Azeem Latib, Federico De Marco
1Department of Interventional Cardiology, Clinical Institute S. Ambrogio, IRCCS San Donato, 20149 Milan, Italy. luctes@gmail.com
Circulation
|February 28, 2013
概括
跨导管大动脉植入后新发病的左捆支部阻塞 (LBBB) 并没有影响长期死亡率. 然而,LBBB与更高的短期需要起器有关.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心脏电生理学 心脏电生理学
背景情况:
- 导电障碍在跨导管大动脉植入 (TAVI) 后很常见.
- 在进行大动脉置换手术后,持续的左束支阻塞 (LBBB) 与不良结果有关.
- 在TAVI之后新发LBBB的预后影响仍然不清楚.
研究的目的:
- 调查新发性持续性LBBB和TAVI后的预后之间的关联.
- 评估LBBB对TAVI后死亡率和心力衰竭住院治疗的影响.
主要方法:
- 对818名使用CoreValve Revalving System进行TAVI的患者进行分析.
- 患者被分为两组:持续的LBBB (n=224) 和没有LBBB (n=594).
- 对比了临床特征,植入细节和长期结果 (死亡率,住院).
主要成果:
- 持续的LBBB与30天或1年后增加的全因死亡率,心脏死亡率或心力衰竭住院治疗无关.
- 在LBBB组30天后观察到更高的心脏起器植入率,但在1年后没有.
- 在LBBB组中,低植入率更频繁.
结论:
- 使用CoreValve系统的TAVI后持续的LBBB不会对硬临床终点产生不利影响.
- LBBB与对心脏起器植入的短期需求增加有关.
- 进一步的研究可能会探索策略,以减轻TAVI后LBBB患者的心脏起器依赖.
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