跨心脏透导管美特拉置换术的使用情况的国家趋势和术后结果
Jake A Awtry1, William Y Shi2, Siobhan McGurk3
1Division of Cardiac Surgery, Brigham and Women's Hospital, Boston, Mass; Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass.
The Journal of thoracic and cardiovascular surgery
|October 15, 2023
概括
透过心腔导管的 mitra 置换 (TAT-TAVR) 显示,在患有 mitra 环状化的高风险患者中,结果有所改善. 最近,死亡率和主要不良心脏事件显著下降,这表明该程序的未来充满希望.
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
- 医疗器械技术 医疗器械技术
背景情况:
- 通过心腔通透管的额头置换 (TAT-TAVR) 为患有额头环结石的高风险患者提供了一种不那么复杂的方法.
- 评估TAT-TAVR利用和患者结果的趋势对于理解其不断变化的作用至关重要.
研究的目的:
- 为了检查使用跨心腔跨导管中枢置换 (TAT-TAVR) 的趋势.
- 为了比较结果,特别是手术死亡率和主要心脏不良事件,在TAT-TAVR早期和最近的时代之间.
主要方法:
- 从胸部外科医生协会数据库 (2014-2021) 来分析经过TAT-TAVR的状环状化患者.
- 排除患有特定并发症的患者,如高伤心肌病或之前的 mitra 门手术.
- 早期 (2014-2017) 和最近 (2018-2021) 时代之间的结果比较使用多变量回归.
主要成果:
- 总共有222个TAT-TAVR程序被确定,每年数量不断增加.
- 与早期相比,最近的时代显示出死亡率显著降低 (3.3%vs25.4%) 和减少主要不良心脏事件 (18.5%vs31.0%) 的趋势.
- 最近的患者更有可能接受选择性手术和胸切除方法,预测的死亡风险相似.
结论:
- 在当代时代,心腔外导管转心替换的结果,包括死亡率和主要心脏不良事件,有了显著的改善.
- 这些改善观察到独立于患者特征或操作因素的变化.
- 在未来,TAT-TAVR 准备在治疗额头环状化的患者方面发挥重要作用.
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