大动脉的假体: 传单不动和血栓
David R Holmes1, Michael J Mack2
1From Department of Cardiology, Mayo Clinic, Rochester, MN (D.R.H.); and Baylor Scott and White Health, Plano, TX (M.J.M.). holmes.david@mayo.edu.
Circulation
|May 3, 2017
概括
在生物假肢主动脉中,叶片静止和血栓是令人担忧的. 四维CT图像显示出诊断这些疾病的最高灵敏度.
科学领域:
- 心血管成像
- 假肢的并发症
- 干预心脏病学
背景情况:
- 传单静止和栓是通过导管和外科主动脉生物假体的已知并发症.
- 这些异常的发病率,临床意义和最佳治疗仍然不确定.
- 影像和程序技术的进步需要对这些并发症有更清晰的理解.
研究的目的:
- 审查当前对主动脉生物假体的叶片不动性和血栓的理解.
- 评估不同成像模式的诊断性能.
- 讨论临床影响和不断发展的治疗策略.
主要方法:
- 对主动脉生物假体并发症的当前文献和临床研究的审查.
- 使用各种成像技术,特别是四维计算机断层扫描 (4D CT) 分析叶片不运动和血栓的诊断准确性.
- 评估与这些门异常相关的发生率,危险因素和临床结果的证据.
主要成果:
- 与心声学相比,四维计算机断层扫描 (4D CT) 在检测叶片不运动和栓症方面表现出最高的灵敏度.
- 确定的诊断依赖于4DCT发现的结合,用抗凝剂进行分辨,以及过导管梯度升高或病理确认.
- 目前正在进行的研究正在调查这些发现的发病率和临床意义,这些发现涉及过导管大动脉置换 (TAVR) 和外科大动脉置换 (SAVR).
结论:
- 四维CT是最灵敏的成像方法,用于诊断大动脉生物假体中的叶片不运动和血栓.
- 进一步的研究对于解决有关这些并发症的发病率,临床意义和最佳管理的不确定性至关重要,特别是在较低风险人群中扩大TAVR的使用.
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