在使用MitraClip治疗功能性腹后的一年结果
Gorav Ailawadi1, D Scott Lim2, Michael J Mack3
1Division of Thoracic and Cardiovascular Surgery (G.A., I.L.K.), University of Virginia, Charlottesville.
Circulation
|December 28, 2018
概括
在患有二次腹症 (SMR) 的患者中,MitraClip程序提供了可接受的安全性和症状改善. 这种跨导管修复减少了SMR的严重程度,并促进了心室重塑,改善了患者的治疗结果.
科学领域:
- 心脏病学
- 干预心脏病学
- 医疗器械
背景情况:
- 二次腹 (SMR) 发生在没有初级膜疾病的情况下,通常是由于左心室变化或叶片绑定.
- 对于SMR的最佳治疗仍然不确定,需要进一步的临床研究.
- 在EVEREST II试验中,对SMR进行过导管中门修复的评估.
研究的目的:
- 评估使用MitraClip设备治疗SMR患者的一年预期的结果.
- 根据手术风险分层结果 (高风险与非高风险).
主要方法:
- 616名SMR患者 (高风险和非高风险) 接受了MitraClip.
- 在基线和1年内收集了临床,心声和功能数据.
- 通过随机试验,高风险注册表和持续访问注册表来判断结果.
主要成果:
- 一年后,76. 8% 的患者无死亡率;84. 7% 的患者MR ≤2+;83. 0% 的患者是NYHA I/ II 级.
- 高风险患者的生存率为74. 1%,而非高风险患者的生存率为86. 4% (P=0. 0175).
- 两组患者的MR减少和左心室体积改善相似;非高风险患者的NYHA类改善更好 (P=0. 008).
- 高风险患者在手术后的心力衰竭住院的数量显著减少.
结论:
- 用MitraClip进行过导管修复对SMR是安全有效的.
- 这种手术可以显著减少MR,缓解症状,并重塑心室.
- MitraClip为SMR患者提供了可行的治疗选择,包括那些具有高手术风险的患者.
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