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发生率和预测因TAVI后高度AV阻塞造成的血液动力学损害的预测因素
Maren Weferling1,2, Stefan Lan Cheong Wah1, Ulrich Fischer-Rasokat1
1Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany.
Frontiers in cardiovascular medicine
|June 22, 2023
概括
通过导管大动脉植入 (TAVI) 后的高度心房静脉阻塞 (HAVB) 可以导致血液动力学妥协 (HC). 后TAVI妄和对比度量独立预测这种严重的并发症,发生在超过10%的病例中.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心脏电生理学 心脏电生理学
背景情况:
- 高度心房静脉阻塞 (HAVB) 是通过导管的大动脉植入 (TAVI) 后经常出现的一种不良事件.
- 由于HAVB引起的血液动力学损害 (HC),虽然很少见,但可能导致昏迷或心肺复苏 (CPR).
- 关于TAVI后HAVB导致的HC发生率和预测因子的数据有限.
研究的目的:
- 为了确定由高度心房静脉阻塞 (HAVB) 引起的血液动力学损害 (HC) 的发生率,经过透气管大动脉植入 (TAVI).
- 确定与TAVI后发生HAVB的患者中HC发展相关的独立预测因子.
主要方法:
- 从2010年到2022年,对4602起TAVI案件进行了回顾性分析.
- 基于HAVB的HC和没有HC的患者之间的基线特征和手术/术后发现的比较.
- 单变量和多变量回归分析以确定HC的独立预测因素.
主要成果:
- 在患有HAVB的患者中,10.5% (49/466) 患有HC.
- 患有高血压的患者住院时间较长,患外围动脉疾病 (PAD) 的患病率较高,血红蛋白水平较低.
- 后TAVI妄和对比剂体积增加被确定为HC的独立预测因素 (分别为OR 3.22和1.01).
结论:
- 血液动力学损害 (HC) 发生在超过10%的高度心房静脉阻塞 (HAVB) 病例中,在经过透管大动脉植入 (TAVI) 后发生.
- 后TAVI妄想的发展和使用的对比剂的数量是HC的显著独立预测因素.
- 这些发现强调了监测妄和管理TAVI患者患HAVB.B.风险的对比体积的重要性.
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