通过导管修复中膜,以治疗退行性中膜反
Raj R Makkar1, Joanna Chikwe1, Tarun Chakravarty1
1Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
JAMA
|May 23, 2023
概括
通过导管修复 mitra 的退行性回 (MR) 是安全和有效的,成功率为88. 9%. 温和的残留MR和较低的部梯度显示出最佳结果,包括较低的死亡率.
科学领域:
- 心血管医学
- 干预心脏病学
- 医疗器械
背景情况:
- 退行性腹 (MR) 显著影响患者的生活质量和死亡率.
- 对于退行性MR的跨导管端到端修复 (TEER) 的现实数据有限.
- 通过导管修复额头为特定患者提供了不那么侵入性的替代手术修复方法.
研究的目的:
- 评估通过导管修复退行性MR的真实结果.
- 在大量患者中评估TEER的安全性和有效性.
- 确定TEER后成功结果的预测因素.
主要方法:
- 使用来自胸部外科医生协会/美国心脏病学会跨导管治疗注册表 (2014-2022) 的数据进行了队列研究.
- 用MitraClip装置对连续接受非突发性透导管边缘至边缘门修复的患者进行了分析.
- 被定义为中度或较少残留的MR,平均位梯度<10 mm Hg. 临床结果的评估是基于残留的MR严重程度和中枢梯度.
主要成果:
- 总共包括了19088名中度至重度退行性MR患者 (中位年龄为82岁;48%为女性).
- 在88. 9%的患者中,MR成功,30天死亡率低 (2. 7%),中风 (1. 2%),再干预 (0. 97%).
- 显著降低1年死亡率 (14. 0% 与 26. 7%) 和心力衰竭再入院率 (8. 4% 与 16. 9%). 患有轻度或较少残留MR和梯度≤5mmHg的患者死亡率最低 (11. 4%).
结论:
- 通过导管修复退行性脑膜是一种安全有效的手术.
- 获得了高的MR成功率,与改善的临床结果相关.
- 获得轻度或较少的残留MR与低位梯度 (< 5 mm Hg) 与最佳生存率相关.
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