叶片血栓瘤对膜血液动力学状况的影响,经过透气管大动脉替换后
Mi Hee Jang1, Jung-Min Ahn2, Do-Yoon Kang2
1Ulsan University Hospital, Ulsan, Korea.
Heart (British Cardiac Society)
|August 16, 2023
概括
低衰减叶片加厚 (HALT) 在经过透气管大动脉置换 (TAVR) 后没有影响膜血液动力学. HALT不是早期结构损坏 (SVD) 的预测因素,但需要更长的随访.
科学领域:
- 心脏病学 心脏病学
- 生物医学工程 生物医学工程
- 放射学 放射学是一门学科.
背景情况:
- 亚临床传单血栓,被确定为低衰减传单增厚 (HALT),是通过导管的大动脉置换 (TAVR) 后的潜在并发症.
- HALT对生物假体门功能和耐用性的临床意义尚不清楚.
- ADAPT-TAVR试验研究了抗凝血与双抗血小板治疗,以预防TAVR后的叶片血栓和栓塞事件.
研究的目的:
- 评估HALT对TAVR后大动脉动力学的影响.
- 为了确定TAVR后早期血液动力学结构恶化 (SVD) 的预测因素.
- 为了确定HALT是否是SVD的预测因素.
主要方法:
- 来自多中心随机化ADAPT-TAVR试验的数据分析.
- 在TAVR后6个月使用4DCT评估HALT.
- 在基线,TAVR后立即,并在6个月后进行序列心声扫描,以评估血液动力学和SVD.
- 由平均梯度,梯度变化或恶化的大动脉反定义的SVD.
主要成果:
- 在6个月后,在14.2%的患者中检测到HALT.
- 在6个月后,在HALT和没有HALT的患者之间没有观察到大动脉梯度平均值的显著差异.
- 年龄较大,生物假体尺寸较小 (≤23毫米),TAVR后梯度较高预测了SVD,但HALT没有.
- 在6个月后,SVD发生在14.6%的患者中.
结论:
- 在TAVR之后,HALT似乎不会影响早期的大动脉的血液动力功能.
- HALT不是早期血液动力学SVD的独立预测因素.
- 需要进行长期跟踪,以充分了解HALT对生物假体门耐用性的影响.
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