患有中级手术风险的患者接受隔离干预或手术大动脉植入治疗严重的症状大动脉缩
Nicolas Werner1, Ralf Zahn2, Andreas Beckmann3
1Medizinische Klinik B, Klinikum Ludwigshafen, Germany (N.W., R.Z.).
Circulation
|December 21, 2018
概括
在中等风险患者中,通过导管的动脉置换 (TAVR) 和手术的动脉置换 (SAVR) 的住院死亡率相似. 在匹配后,TAVR和SAVR之间的1年死亡率没有显著差异,这表明结果相似.
科学领域:
- 心脏病学
- 干预心脏病学
- 心脏外科
背景情况:
- 在中等风险患者中,越来越多地使用过导管大动脉置换 (TAVR).
- 在这一群体中,与TAVR和外科动脉置换 (SAVR) 进行比较的现实数据有限.
研究的目的:
- 为了比较隔离TAVR和SAVR的中等风险患者的临床特征和结果.
- 在现实环境中评估TAVR与SAVR的安全性和有效性.
主要方法:
- 来自德国大动脉注册表的7613名患者的分析 (2012-2014).
- 患者接受了单独的TAVR (n=6469) 或SAVR (n=1144) 治疗,手术风险中等 (STS得分为4%- 8%).
- 使用倾向性得分匹配来调整基线差异.
主要成果:
- 与SAVR患者相比,TAVR患者年龄较大,基线风险得分较高.
- 在TAVR和SAVR中,住院死亡率相似 (3.6%).
- 在TAVR (17. 5%) 后,未调整的1年死亡率较高,但在倾向性得分匹配后没有显著差异 (17. 1% 与 15. 7% 相比).
结论:
- 接受TAVR的中等风险患者与接受SAVR的患者在年龄和基线特征上有显著差异.
- TAVR和SAVR的住院死亡率相似.
- 倾向性评分分析表明TAVR和SAVR之间的1年死亡率没有显著差异,这表明长期结果相似.
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