心肌梗塞后心室隔膜缺陷的跨导管闭合:系统性审查和单臂元分析
Kang Yi1,2,3, Chengfei Liu4, Zhi Xu2,5
1Department of Cardiovascular Surgery, Gansu Provincial Hospital, Lanzhou, China.
Heliyon
|June 12, 2023
概括
心肌梗塞后心室隔膜缺陷 (PMIVSDs) 的跨导管关闭是急性病例中可行的救援选择,在慢性阶段更有效. 然而,剩余的分流仍然是一个问题,需要进一步的研究.
科学领域:
- 心脏病学 心脏病学
- 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:
- 心室隔膜缺陷 (VSD) 是急性心肌梗塞 (AMI) 后的严重机械并发症.
- 与传统的手术修复相关的高死亡率和并发症率需要替代治疗方法.
- 透导管关闭已经成为心肌梗塞后静脉瘤 (PMIVSDs) 的有希望的替代方案.
研究的目的:
- 评估PMIVSDs跨导管封闭的可行性和安全性.
- 分析成功率,死亡率和并发症发生率.
- 评估这种干预方法的有效性.
主要方法:
- 对12项单臂研究的元分析,涉及284名患者.
- 分析VSD和设备大小,手术前风险因素和干预措施.
- 通过导管关闭的成功率,30天死亡率和残留分流发生率的评估.
主要成果:
- 术前并发症的高发病率:高血压 (66%),高脂血 (54%) 和糖尿病 (33%).
- 之前的干预常见:PCI (46%),IABP (60%),CABG (8%). 在过去的干预中,PCI (46%),IABP (60%),CABG (8%) 是常见的.
- 成功关闭率为90%,30天死亡率为27%.
结论:
- 过导管关闭是急性PMIVSD的关键救援策略,在慢性病例中较低死亡率更有效.
- 选择偏差可能会影响慢性期治疗的结果.
- 剩余分流的高发病率需要进一步调查和大规模的随机试验来确认安全性和可靠性.
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