透导管后感染性内心炎与手术大动脉置换相比
Vassili Panagides1, Guillermo Cuervo2, Jaume Llopis3
1Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada.
概括
手术性大动脉置换 (SAVR) 后的传染性内心炎 (IE) 和过导管大动脉置换 (TAVR) 尽管有不同的临床表现和微生物学,但1年死亡率相似. 这项比较研究突出了IE管理和这些程序的结果的关键差异.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 假肢的并发症 假肢的并发症
背景情况:
- 有限的比较数据存在于感染性内心炎 (IE) 后的外科动脉置换 (SAVR) 和透气管动脉置换 (TAVR).
- 了解IE表现,微生物学,管理和这些程序后的结果对于患者护理至关重要.
研究的目的:
- 为了比较临床特征,微生物学概况,管理策略和IE的结果,在接受SAVR和TAVR的患者中进行IE.
- 为了确定手术生物假体 (SB) 上发生的IE的差异和相似之处,与跨导管心脏相比.
主要方法:
- 利用了来自"TAVR国际后传染性内心炎"和"内心炎国际合作"注册表的数据.
- 采用1:1匹配队列分析,比较影响SAVR (特别是手术生物假体) 和TAVR假体的IE患者.
- 包括1688名患者,与匹配的人口进行比较分析.
主要成果:
- 与TAVR相比,SAVR组 (外科活体假体) 显示出较高的新中度/重度大动脉吐率 (43.4%与13.5%) 和周围膜延伸率 (47.9%与27%).
- 在SAVR组中诊断的植被较少 (62.5%与82%相比),金黄色葡萄球菌较少 (13.4%与22%).
- 尽管SAVR组的重复手术率较高 (44.4%对27.3%),但1年死亡率相似 (46.5%对44.8%).
结论:
- 在SAVR (SB) 和TAVR之间,IE的临床表现,致病微生物和治疗方法存在显著差异.
- 尽管存在这些差异,但这两组患者在感染性内心炎后的1年死亡率都很高,并且可以比较.
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