失败过导管大动脉置换术的外科解释
Syed Zaid1, Sameer A Hirji2, Vinayak N Bapat3
1Division of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas.
The Annals of thoracic surgery
|June 24, 2023
概括
过导管大动脉置换 (TAVR) 和同时进行手术后的外科探索显示死亡率增加. 在TAVR患者出现进一步并发症之前,早期干预可能是有益的.
科学领域:
- 心血管外科心血管外科
- 干预心脏病学 干预心脏病学
- 医疗器械产生的结果
背景情况:
- 过导管大动脉置换 (TAVR) 后的外科探索已经显示出不理想的结果.
- 有限的数据存在于TAVR探索期间与并发心脏手术相关的风险.
研究的目的:
- 分析TAVR探索期间同时进行心脏手术的短期和中期风险.
- 为了比较 TAVR 开口手术过程中隔离和并发性大动脉置换手术 (SAVR) 之间的结果.
主要方法:
- 对EXPLANT-TAVR注册表的回顾性分析 (2009年11月 - 2020年9月).
- 包括接受TAVR扩展和并发手术的患者,不包括同一入院TAVR或大动脉根/门手术.
- 隔离SAVR和并发SAVR组之间的结果比较,随访时间中位数为6.6个月.
主要成果:
- 同时的SAVR (47.2%) 经常与 mitra 门手术或冠状动脉旁路移植相结合.
- 同时服用SAVR患者的预测死亡风险更高,心肺旁路和十字时间更长.
- 虽然同时服用组的30天和1年死亡率较高,但只有3年生存率明显较低 (56.8%vs81.1%,P=.020).
结论:
- 在TAVR探索期间同时进行大动脉置换手术与增加的死亡率有关.
- 需要进行进一步的随访研究,以评估早期干预对发展并发性疾病的优势.
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