通过导管切换大动脉替换后,再进行干预的长期风险
Suzanne J Baron1, Michael P Ryan2, Soumya G Chikermane3
1Massachusetts General Hospital, Boston, MA; Baim Institute for Clinical Research, Boston, MA.
American heart journal
|October 23, 2023
概括
透气管大动脉置换术 (TAVR) 后重新进行门干预的10年风险很低,为1.63%. 随着时间的推移,这种风险正在减少,这表明TAVR患者的长期结果有所改善.
科学领域:
- 心脏病学 心脏病学
- 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:
- 超导管大动脉置换 (TAVR) 现在是治疗严重大动脉狭窄的主要方法,超过了手术大动脉置换 (SAVR).
- 在TAVR后重复门手术的长期必要性尚未得到广泛研究.
研究的目的:
- 评估TAVR后门再干预的长期风险.
- 评估TAVR再干预率随着时间的推移的趋势.
主要方法:
- 2011年7月至2020年12月使用的医疗保险服务费用数据.
- 识别了TAVR患者,并根据随后的门再干预使用ICD-10-PCS代码对其进行了分类.
- 采用竞争风险回归模型来估计累积的再干预概率.
主要成果:
- 确定了230,644名TAVR患者;1,880人需要重新干预.
- 粗略的10年再干预率为0.59%.
- 经调整后的10年累计再干预发生率为1.63%,在2011-2016年和2017-2020年之间观察到风险调整后的下降率 (0.85%与4年后的0.51%)
结论:
- 在TAVR后的门再干预的10年风险很低.
- 重复干预率似乎正在下降,这表明TAVR耐久性或患者选择的潜在改善.
- 需要进一步的研究,以了解在当前的TAVR时代推动重新干预的因素.
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