早期使用Evolut FX自扩张的经验与Evolut PRO+对于接受TAVR的大动脉狭窄患者的早期经验
Ilan Merdler1, Brian Case1, Sukhdeep Bhogal1
1MedStar Heart & Vascular Institute, MedStar Washington Hospital Center, Washington, DC, United States of America; MedStar Georgetown University Hospital, Washington, DC, United States of America.
概括
新的Evolut FX跨导管心脏 (THV) 在严重的大动脉狭窄患者中显示出有前途的早期结果. 这一最新一代THV技术与以前的模型相比,显示出高成功率和低并发症率.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 医疗器械 医疗器械
背景情况:
- 进化FX系统代表了最新一代的自扩展式透气管心脏门 (THV) 技术.
- 严重的大动脉狭窄需要先进的治疗选择,以改善患者的治疗结果.
研究的目的:
- 评估Evolut FX THV系统的早期临床经验和程序结果.
- 为了比较Evolut FX THV与其前身Evolut PRO+ THV的表现.
主要方法:
- 对200名连续接受过透管大动脉置换 (TAVR) 的患者进行比较分析.
- 研究了两个队列:接受Evolut PRO+ THV的100名患者和接受Evolut FX THV的100名患者.
- 结果使用门学术研究联盟-3 (VARC-3) 标准进行评估,重点关注技术成功,设备成功和30天的早期安全性.
主要成果:
- 两种THV系统都显示了99%的VARC-3技术成功率.
- 对于Evolut PRO+,VARC-3设备的成功率为97%,对于Evolut FX (p=0.12),成功率为92%.
- 早期VARC-3安全率相似:Evolut PRO+的安全率为80.1%,而Evolut FX的安全率为81.5% (p=0.82).
- 在医院内永久心脏起器植入率为Evolut PRO+的9%,Evolut FX的12% (p=0.21).
- 在临床结果,如死亡率或中风等方面,两组之间没有发现显著差异.
结论:
- Evolut FX THV是治疗严重的大动脉狭窄症的高性能设备.
- 它实现了高的成功率和低的并发症率,与早期的自扩展THV代相美.
相关概念视频
Aortic Regurgitation I: Introduction
18
IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
18
Aortic Regurgitation III: Medical Management
26
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
26
Mitral Stenosis I: Introduction
18
Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
18
Mitral Valve Prolapse I: Introduction
22
IntroductionThe mitral valve, one of the heart's four valves, regulates blood flow. These valves have flaps that open and close to direct blood properly through the heart and body. During each heartbeat, the flaps open for blood to pass through and seal shut to prevent backflow. Specifically, the mitral valve opens to allow blood flow from the heart's upper left chamber to the lower left chamber. It then closes securely as the lower left chamber contracts to pump blood to the body, preventing...
22
Mitral Valve Prolapse II: Assessment and Management
23
IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular...
23
Mitral Stenosis III: Medical Management
13
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
13


