荷兰的国家指示文件和大动脉置换景观
Rob Eerdekens1, Gijs van Steenbergen1, Mohamed El Farissi1
1Department of Cardiothoracic Surgery and Cardiology, Catharina Hospital, Eindhoven, The Netherlands.
概括
跨导管大动脉植入 (TAVI) 的2021年荷兰指示文件并没有显著改变外科大动脉置换 (SAVR) 与TAVI的格局,因为患者数量和比率在实施后保持稳定.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 卫生政策 卫生政策
背景情况:
- 欧洲指导方针建议在75岁或以上的患者中进行过导管大动脉植入 (TAVI) 治疗严重的大动脉狭窄.
- 荷兰于2021年1月1日生效的一份国家指示文件规定了TAVI的退款标准.
- 医疗保健提供者和国家医疗保健研究所之间的辩论在指示文件实施之前.
研究的目的:
- 评估2021年荷兰国家指示文件对跨导管大动脉植入 (TAVI) 与手术大动脉置换 (SAVR) 的利用的影响.
- 分析患者选择的趋势和TAVI与SAVR程序的比率,在指示文档实施之前和之后.
主要方法:
- 分析了来自荷兰心脏登记处 (2018-2021) 的手术大动脉置换 (SAVR) 和透气管大动脉植入 (TAVI) 的数据.
- 对TAVI患者的基线特征进行了跨年比较.
- 年度SAVR/TAVI比率和趋势的评估是根据指示文件的有效日期进行的.
主要成果:
- 在2018年至2021年期间,SAVR和TAVI程序的总数保持不变.
- 接受TAVI治疗的患者人口统计学在研究期间没有显著变化.
- 从2018-2019年,SAVR/TAVI比率略微向TAVI转移,从2019-2020年保持稳定,并在2021年指示文件实施后没有显著变化.
结论:
- 2021年荷兰实施大动脉置换 (AVR) 国家指示文件并没有导致SAVR与TAVI程序格局的重大转变.
- 该研究表明,确定的标准并没有显著改变严重大动脉狭窄症的现有治疗趋势.
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