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在中等风险患者中,SAPIEN 3 跨导管大动脉置换与手术置换相比的结果

Mahesh V Madhavan¹, Susheel K Kodali², Vinod H Thourani³

¹Columbia University Irving Medical Center and NewYork-Presbyterian Hospital, New York, New York, USA; Cardiovascular Research Foundation, New York, New York, USA.

Journal of the American College of Cardiology

|July 5, 2023

概括

在中等风险患者中,使用SAPIEN 3生物假体进行过导管大动脉置换 (TAVR) 与手术大动脉置换 (SAVR) 相比,显示出类似的5年生存率和中风率. 然而,TAVR具有较高的副膜吐率.

科学领域:

心脏病学心脏病学
干预心脏病学干预心脏病学
心脏外科手术心脏外科手术

背景情况:

之前的研究表明,在5年以后的中等风险患者中,用较早的门进行过导管大动脉置换 (TAVR) 与外科大动脉置换 (SAVR) 无差.
对于TAVR手术中的当代SAPIEN 3 (S3) 生物假体的长期数据有限.

研究的目的:

为了比较SAPIEN 3 TAVR和SAVR之间的5年风险调整后的结果,在中等风险的严重大动脉狭窄患者中.

主要方法:

倾向性得分匹配用于比较PARTNER 2 S3单臂研究 (TAVR) 和PARTNER 2A试验 (SAVR) 中的中等风险患者.
主要终点是5年全因死亡和致残性中风的复合结果.

主要成果:

在783个匹配对中,在5年后S3 TAVR和SAVR之间的初级终点中没有发现显著差异 (40.2%对42.7%).
在S3 TAVR后,轻度或较大的副膜反更为频繁.
在结构损坏相关的血液动力学损坏或生物假体故障方面,两组之间没有发现差异.

结论:

在中等风险患者中,S3 TAVR和SAVR的五年死亡率和致残性中风率相似.
虽然门的耐用性是可比的,但在S3 TAVR.中,对膜吐更为常见.
需要进行进一步的长期随访,以评估晚期临床事件和生物假体门的耐用性.

关键词:

大动脉狭窄症是什么大动脉门更换术手术上更换大动脉门.通过导管更换大动脉门.

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