随着气球可扩展的跨导管大动脉置换过程中的大动脉根裂相关的解剖学和程序特征
Marco Barbanti1, Tae-Hyun Yang, Josep Rodès Cabau
1St Paul’s Hospital, Vancouver, BC, Canada.
Circulation
|June 11, 2013
概括
在跨导管大动脉置换 (TAVR) 期间的大动脉根裂与左心室外流通道 (LVOT) 化和门过大有关. 识别这些预测因素可以帮助减轻TAVR程序中的破裂风险.
科学领域:
- 心血管成像 - 心血管成像
- 干预心脏病学 干预心脏病学
- 生物医学工程 生物医学工程
背景情况:
- 大动脉根断裂是气球可扩展的跨导管大动脉置换 (TAVR) 的严重并发症.
- 预测和预防这种破裂对于TAVR手术期间的患者安全至关重要.
研究的目的:
- 在接受气球可扩展TAVR的患者中确定大动脉根裂的预测因子.
- 使用多探测器计算机断层扫描 (MDCT) 进行风险评估.
主要方法:
- 一项病例对照研究比较了TAVR期间31名大动脉根裂患者与31名没有破裂的匹配对照.
- 在MDCT分析中,测量了管结,环和LVOT,以及化评估.
- 采集了手术前的临床和心声回声数据,并在各组之间进行了比较.
主要成果:
- 与对照组相比,患有大动脉根裂患者的LVOT/亚管化程度 (阿加斯顿得分) 显著更高.
- 在破裂组中观察到更高频率的假肢超大 (≥20%的环形面积).
- 中度/严重的LVOT/下形化和假肢超大尺寸≥20%独立地与大动脉根裂相关.
结论:
- LVOT化和积极的环状区域过大是TAVR期间大动脉根裂的重要危险因素.
- 建议对更大的队列进行进一步研究,以验证这些发现并完善风险分层.
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