在接受MitraClip的患者中,退院后至30天的死亡率:系统性审查和元分析
Beni R Verma1, Shashank Shekhar1, Toshiaki Isogai1
1Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Structural heart : the journal of the Heart Team
|June 5, 2023
概括
植入MitraClip (MC) 的患者在出院后30天死亡率约为2%,主要是心脏病. 关键预测因素包括低射出分数和高的外科风险得分. 需要进一步的研究来减少这种早期死亡率.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 医疗器械技术 医疗器械技术
背景情况:
- 在高手术风险患者中,MitraClip (MC) 植入是严重症状的额头骨吐的关键治疗方法.
- 了解立即术后死亡率对于改善治疗结果至关重要.
- 这项研究侧重于MC植入后的退院后至30天死亡期.
研究的目的:
- 为了确定医院出院和MitraClip植入后30天之间的死亡率.
- 为了确定这种早期出院后死亡率的显著预测因素.
- 为改善MitraClip手术后患者治疗结果的策略提供信息.
主要方法:
- 通过使用来自Medline,Embase和Cochrane CENTRAL数据库的数据进行了元分析.
- 包括的研究报告了出院,30天和MC植入后1年的死亡率.
- 分析的主要结局是退院后至30天期间的全因死亡率.
主要成果:
- 分析包括15项研究,涉及7498名患者.
- 退院后至30天的所有原因死亡率为1.70%.
- 心脏病原因约占这些早期死亡的71.50%.
- 确定了重要的预测因素是MC前的左心室喷射分数,Log.Euroscore,STS预测死亡风险和长时间通风.
结论:
- 在MitraClip植入后的30天内,发生大约2%的额外死亡率,主要是由于心脏事件.
- 诸如左心室喷射率降低和手术风险得分升高等因素预测了这种早期死亡率.
- 需要进一步的研究,以阐明早期死亡的原因,并优化MitraClip治疗的好处.
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