在跨导管 mitra 门更换之前,预防性酒精隔膜切除
Ningyan Wong1,2, D Scott Lim1, Kenan Yount1
1Advanced Cardiac Valve Center, University of Virginia, Charlottesville, Virginia, USA.
概括
酒精隔膜切除 (ASA) 有效地增加左心室外流通道 (LVOT) 区域,用于跨导管 mitra 置换 (TMVR). 这种程序在约90%的患者中是成功的,使得安全的TMVR设备植入.
科学领域:
- 干预心脏病学 干预心脏病学
- 心脏外科手术 心脏外科手术
- 心血管成像 - 心血管成像
背景情况:
- 已知酒精隔膜切除 (ASA) 在跨导管中枢置换 (TMVR) 之前增加了新左心室外流通道 (LVOT) 区域.
- 关于ASA与专用TMVR设备的成功和应用的文献有限.
研究的目的:
- 评估先发性ASA在增加预测的新-LVOT区域方面的经验.
- 评估ASA与专用TMVR设备和气球可扩展的实用性.
主要方法:
- 对12名接受TMVR候选ASA的患者进行回顾性审查 (2018年5月 - 2022年10月).
- 在ASA之前和之后的计算机断层扫描 (CT) 扫描被分析,以确定末缩时预测的最小新-LVOT区域.
- 主要结局:预测的新低空视频区域的增加足以安全地植入TMVR设备. 二次结果:TMVR后没有急性LVOT阻塞.
主要成果:
- 12名患者中有11名 (91.6%) 在ASA后实现了足够的预测新-LVOT区域.
- 新-LVOT面积的平均增加为126 ± 64 mm2.
- 九名患者在没有LVOT阻塞的情况下进行了成功的TMVR;两人需要ASA后的永久起器.
结论:
- 预防性ASA可以在约90%的适当选择的患者中获得足够的TMVR新-LVOT清除.
- 这种方法在经验丰富的中心的各种TMVR设备上是有效的.
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