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通过横管甲状腺膜植入通过肋间接入:初次使用无触摸技术的经验

Nina Sophie Pommert^1,2, Xiling Zhang¹, Thomas Puehler^1,2

¹Department of Cardiac and Vascular Surgery, University Medical Center Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany.

Journal of clinical medicine

|August 26, 2023

概括

通过肋间胸腔切除术进行的跨门TAVI是一种安全有效的替代方案,可用于治疗大动脉狭窄的小型胸腔切除术. 这种节省胸骨的方法显示了可比的生存率和减少并发症.

科学领域:

心血管外科心血管外科
干预心脏病学干预心脏病学
胸部外科手术胸部外科手术

背景情况:

过导管大动脉植入 (TAVI) 是老年,高风险的患有大动脉疾病的患者的关键治疗.
虽然骨转移性TAVI是常见的,但替代的骨转移性方法正在发展.
通过迷你胸腔切除术来节省胸骨和肋骨的门是迷你胸腔切除术的替代方案.

研究的目的:

为了比较使用迷你胸腔切除方法与经典的上部迷你胸腔切除术的跨门TAVI的结果.
评估TAVI的肋间间方法的安全性和有效性.

主要方法:

对173名接受跨门TAVI的患者进行了回顾性研究 (2017年1月 - 2020年4月).
患者被分为两个组:上部迷你胸口切除术 (n=82) 和肋间胸口切除术 (n=91).
主要终点:30天死亡率. 二级终点:主要的术后并发症,ICU入院和住院 (VARC-3标准).

主要成果:

肋间间组的外周和冠状动脉疾病发病率较高,这表明介入前风险较高 (EuroScore II 8%与4%相比).
在所有情况下,设备植入都取得了成功. 肋间间组显示出明显较低的副膜泄漏率 (12%vs33%),需要更少的输血 (0vs2单位),并且住院时间更短 (9vs12天).
短期和长期存活率在各组之间是可比的 (30天死亡率:7%的肋间间与9%的TAo). 急性损伤和再输卵是死亡率的独立风险因素.

结论:

通过肋间间通道进行的跨门TAVI是对大动脉狭窄的安全有效治疗方法.
胸骨和肋骨节约的肋间间方法在减少膜漏水和缩短住院时间方面具有优势.
这种技术为接受关TAVI的患者提供了可行的替代方案.

关键词:

塔维 (Tavi) 是一个古老的城市.大动脉门更换术肋间间间的肋间间间的最少的侵入性手术是最少的侵入性手术.交易部门的TAVI.

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