经过透气管中枢内或环内手术后的长期结果
Manuel Wilbring1, Asen Petrov1, Sebastian Arzt1
1Department of Cardiac Surgery, University Heart Center Dresden, Fetscherstrasse 76, 01307 Dresden, Germany.
Journal of personalized medicine
|May 27, 2023
概括
过导管 mitra valve-in-valve (ViV) 和 valve-in-ring (ViR) 程序为高风险患者提供了替代方案,但长期的结果令人失望,有显著的残留吐和高死亡率,特别是在ViR.
科学领域:
- 心血管医学 心血管医学
- 干预心脏病学 干预心脏病学
- 心脏外科手术 心脏外科手术
背景情况:
- 重新修复 mitra 门手术是生物假体失败或修复失败的标准.
- 导管式内 (ViV) 和内环 (ViR) 是高危患者的替代方案.
- 需要进一步研究通过导管对称ViV和ViR手术的长期结果.
研究的目的:
- 报告跨导管部ViV和ViR手术的长期结果.
- 在高风险人群中评估这些最小侵入性干预措施的有效性和安全性.
主要方法:
- 在2011年至2021年期间,回顾性招募了54名高风险患者,这些患者在2011年至2021年期间接受过导管关ViV或ViR治疗.
- 程序使用商业上可用的气球可扩展的透气管心脏门.
- 分析了临床和心声学数据,随访时间长达9.9年 (164.3个患者年).
主要成果:
- 程序成功率 (VARC-2) 很低,主要是由于高的跨膜压力梯度和残留吐.
- 尽管30天死亡率可以接受,但医院后平均存活率很低 (ViV为3.9年,ViR为2.3年).
- 总生存率为33.3%,心脏病原因频繁;ViR程序预测死亡率 (HR 2.36).
结论:
- 在高风险患者中,通过导管对称ViV和ViR手术的长期结果令人丧.
- 持续的跨膜压力梯度和残留吐仍然是显著的缺点.
- 仔细考虑指示与传统的重复手术或保守的管理是至关重要的.
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