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时间到TAVI:简化治疗的途径

Lynsey Jane Hewitson¹, Suzane Cadiz², Sameeha Al-Sayed²

¹Great Western Hospitals NHS Foundation Trust, Swindon, UK lynsey.hewitson@nhs.net.

|September 4, 2023

概括

一个新的跨导管大动脉植入 (TAVI) 途径简化了患者的局部治疗,大大减少了治疗延迟和改善了TAVI接受率. 这种方法提高了重症大动脉狭窄患者获得TAVI的机会.

科学领域:

心血管医学心血管医学
干预心脏病学干预心脏病学
医疗保健服务研究医疗服务研究

背景情况:

严重的大动脉狭窄带来了严重的发病率和死亡率风险.
传统的跨导管大动脉植入 (TAVI) 途径依赖于三级心脏门中心,往往导致治疗延迟.
现有的延迟违反了英国心血管干预协会的目标,需要优化途径.

研究的目的:

评估一种新的TAVI转诊途径,强调本地全面的患者工作.
评估这一新途径对TAVI及转介接受率及时的影响.
为了确定本地工作是否改善了TAVI的可访问性.

主要方法:

从2020年11月到2021年11月,对TAVI转介的回顾性数据收集.
时间比较从推到TAVI的中心与一个新的本地工作途径和传统途径之间的时间比较.
对新路径的总路径时间 (TAVI的心声诊断) 的分析.
对TAVI的转介接受率的二次分析.

主要成果:

新的途径显著减少了从转诊到TAVI的平均时间 (32.4天对126天,p<0.00001).
从诊断到TAVI的总途径时间比传统的转诊时间显著短 (89.9天) (p<0.003).
在新途径中,TAVI的推接受率明显高 (97.8%与49.5%,p<0.00001).

结论:

在非手术中心,具有局部功效的TAVI途径显著减少了TAVI手术时间和排斥率.
这种优化的途径改善了患者对TAVI的访问.
这种方法的广泛采用可以提高TAVI在各中心的可访问性.

关键词:

大动脉狭窄症大动脉狭窄症提供医疗保健服务.诊断成像诊断成像诊断成像流行病学流行病学通过导管更换大动脉门

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