计算机断层扫描的解剖学特征基于在主动脉回中通过导管进行主动脉替换
Yang Chen1, Jie Zhao1, Qingrong Liu1
1Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, 167 Beilishilu, Xicheng District, Beijing, 100037, China.
The international journal of cardiovascular imaging
|July 8, 2023
概括
计算机断层扫描 (CT) 分析显示,有主动脉反 (AR) 患者的解剖学变异不适合当前透气管主动脉置换 (TAVR). 一种新型的自我扩张的横导管心脏 (THV) 显示出改善TAVR适应性的潜力.
科学领域:
- 心血管成像和干预方法
- 结构性心脏病是一种心脏病.
- 用于设备设计的解剖学分类.
背景情况:
- 大动脉反 (AR) 由于患者特定的解剖变异,对过导管大动脉置换 (TAVR) 提出了挑战.
- 准确的CT测量对于评估TAVR候选性和优化设备选择至关重要.
- 现有的透气管心脏门 (THV) 可能无法充分解决AR患者多样化的解剖现象.
研究的目的:
- 总结CT测量特征和在接受TAVR的AR患者的解剖学分类.
- 根据已识别的解剖特征设计一种新的自我扩展THV.
- 评估新型THV在改善TAVR结果方面的理论可行性.
主要方法:
- 对136名中度至重度AR患者进行了回顾性队列研究.
- 双定多平面CT测量大动脉环,左心室外流通道 (LVOT) 和上升大动脉 (AA).
- 开发一个四种类型的解剖学分类系统THV定和设计一个新的THV.
主要成果:
- 很大一部分AR患者 (22.8%年圆,37.5%LVOT,50.0%AA) 没有达到10%THV超大尺寸标准.
- 解剖学分类显示1-4类型的比例分别为32.4%,5.9%,30.1%和31.6%.
- 新的THV设计理论上提高了1型适用性到88.2%.
结论:
- 在AR患者的TAVR规划中,CT衍生的解剖学分类是必不可少的.
- 现有的THV在适应AR患者的解剖学多样性方面存在局限性.
- 这种新型的自我扩展THV通过解决特定的解剖学挑战,显示出增强TAVR可访问性和有效性的潜力.
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