在中等风险患者中,通过导管置换主动脉与手术置换:倾向性评分分析
Vinod H Thourani1, Susheel Kodali2, Raj R Makkar3
1Emory University School of Medicine, Atlanta, GA, USA.
Lancet (London, England)
|April 8, 2016
概括
使用SAPIEN 3门进行的透气导管大动脉置换 (TAVR) 与中等风险的严重大动脉狭窄患者的手术相比显示出更好的结果. 这项研究发现,TAVR在一年后降低死亡率,中风和吐率方面不逊色而优越.
科学领域:
- 心血管医学
- 干预心脏病学
- 医疗技术评估
背景情况:
- 在中等风险的手术患者中,严重的大动脉狭窄带来重大风险.
- 使用SAPIEN 3门进行过导管大动脉置换 (TAVR) 已经显示出有前途的早期结果.
- 在这一群体中,TAVR与手术置换的长期比较数据至关重要.
研究的目的:
- 报告接受SAPIEN 3 TAVR的中等风险患者的一年结果.
- 将这些结果与接受大动脉置换手术 (SAVR) 的中等风险患者进行比较.
- 评估TAVR与SAVR在严重的大动脉狭窄的疗效和安全性.
主要方法:
- 在接受SAPIEN 3 TAVR治疗的1077名中等风险患者中进行了前性观察研究.
- 一年内全因死亡率,中风,再干预和主动脉吐的评估.
- 倾向性评分分析,将TAVR结果与PARTNER 2A试验的历史SAVR数据进行比较.
主要成果:
- 在1年后,TAVR患者的全因死亡率为7. 4%,中风为2%,重复干预为1%,中度/重度吐为2%.
- 倾向性评分分析包括963名TAVR和747名SAVR患者.
- 与SAVR相比,TAVR在死亡,中风和中度/重度吐的综合终点上表现出非劣势和优势.
结论:
- 在中等风险的重症大动脉狭窄患者中,SAPIEN 3 TAVR与1年的良好结果有关.
- 在初级复合终点上,TAVR显著优于SAVR.
- 对于中等风险的严重大动脉狭窄患者来说,TAVR可能是首选的治疗方案.
相关概念视频
Aortic Regurgitation III: Medical Management
545
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
545
Mitral Stenosis III: Medical Management
426
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
426
Aneurysm III: Interprofessional Care
441
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
441
Aortic Regurgitation I: Introduction
1.1K
IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
1.1K


