用气球扩展替换多次透气管大动脉的结果:注册研究
Raj R Makkar1, Samir Kapadia2, Tarun Chakravarty1
1Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Lancet (London, England)
|September 3, 2023
概括
使用气球可扩展的再通气管大动脉置换 (TAVR) 对于失败的TAVR是安全有效的. 结果,包括死亡率和中风率,与匹配患者的初始TAVR程序相似.
科学领域:
- 心血管医学
- 干预心脏病学
- 医疗器械
背景情况:
- 越来越多地使用过导管大动脉置换 (TAVR),需要了解失败的TAVR的管理.
- 重复TAVR (重复TAVR) 是TAVR故障的一个新兴选择.
研究的目的:
- 用气球扩展来评估重复TAVR的安全性和有效性.
- 为了将回复TAVR的结果与原生门的TAVR进行比较.
主要方法:
- 来自STS/ACC TAVT注册表的患者分析 (2011-2022年).
- 通过倾向性得分匹配,与原生TAVR队列进行再处理TAVR的比较.
- 对手术,心声和临床结果的评估.
主要成果:
- 复制TAVR的手术并发症率低,与原生TAVR相似.
- 在回复TAVR和本源TAVR之间,30天或1年死亡率和中风率没有显著差异.
- 重新TAVR降低了主动脉梯度,但在1年内仍然高于原始TAVR.
结论:
- 用气球扩展进行重复TAVR对于失败的TAVR是有效的,并发症很小.
- 在选定的患者中,结果与初始的TAVR相似.
- 对于失败的TAVR,重新TAVR可能是一个合理的治疗选择.
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