使用新一代跨导管器件的内两年结果与Redo-SAVR相比
Takashi Nagasaka1, Ofir Koren2, Vivek Patel3
1Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California; Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Gunma, Japan.
The American journal of cardiology
|October 1, 2023
概括
较新的门内透导管大动脉替换 (ViV-TAVR) 与重新手术性大动脉替换 (Redo-SAVR) 的长期存活率相似. 此外,ViV-TAVR还显示了较少的住院并发症.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心脏外科手术 心脏外科手术
背景情况:
- 过导管大动脉置换 (TAVR) 是对大动脉狭窄的常见治疗方法.
- 很少有研究直接将新一代门内TAVR (ViV-TAVR) 与重新手术的大动脉置换 (Redo-SAVR) 进行比较.
- 了解比较结果对于患有退化生物假体门的患者的治疗选择至关重要.
研究的目的:
- 为了比较ViV-TAVR使用新一代门与Redo-SAVR的临床结果.
- 为了评估死亡率,中风,心力衰竭,再住院和住院并发症的差异.
- 在现实环境中评估ViV-TAVR的长期疗效和安全性.
主要方法:
- 在2015-2021年期间接受ViV-TAVR或Redo-SAVR的患者的回顾性比较.
- 使用倾向性得分匹配 (PSM) 分析来控制基线特征差异.
- 主要终点:所有原因的死亡率在30天和2年. 二级终点包括程序结果和并发症.
主要成果:
- 在PSM之后,ViV-TAVR和Redo-SAVR组之间30天 (3.9%对2.6%) 或2年 (6.5%对7.8%) 的全因死亡率没有显著差异.
- 在30天和2年后,在两组中观察到类似的中风和心力衰竭再住院率.
- ViV-TAVR组的累积住院并发症率明显较低 (11.7%与28.6%相比).
结论:
- 新一代ViV-TAVR提供了与Redo-SAVR相比较的长期临床结果.
- 与Redo-SAVR相比,ViV-TAVR与医院内并发症的显著减少有关.
- 对于需要主动脉再干预的患者来说,ViV-TAVR是一种安全有效的替代方案.
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