生物假体叶片血栓瘤和通过导管的大动脉替换后的叶片运动减少:系统性审查和元分析
Vincent Roule1, Paul Guedeney2, Johanne Silvain2
1ACTION Study Group, Sorbonne Université, UMRS 1166, Institut de Cardiologie, Pitié-Salpêtrière Hospital (AP-HP), 75013 Paris, France; Service de Cardiologie, CHU de Caen Normandie, Normandie Université, 14000 Caen, France.
Archives of cardiovascular diseases
|November 15, 2023
概括
过导管大动脉置换术 (TAVR) 后的叶片血栓形成是可变的,受查方法和抗凝药的影响. 虽然没有影响生存,但小叶血栓和运动减少会增加中风风险.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 生物材料科学 生物材料科学
背景情况:
- 传单血栓和传单运动减少是跨导管大动脉置换 (TAVR) 后的新兴问题,特别是在低风险患者群体中.
- 越来越多地使用TAVR需要对这些并发症有彻底的了解.
研究的目的:
- 为了确定TAVR后的叶片血栓形成和叶片运动减少的患病率,预测因素和临床意义.
- 分析这些发现对患者结局的影响,包括死亡率和中风.
主要方法:
- 进行了一项全面的元分析,汇集了来自53项涉及25258名接受TAVR的患者的研究数据.
- 使用计算机断层扫描和心声回声扫描评估了传单血栓和传单运动减少.
主要成果:
- 叶片血栓的总发病率为5.2%,计算机断层扫描 (16.4%) 检测到的发病率高于心声回声 (1.1%).
- 内生物假体与增加的叶片血栓形成有关,而慢性口服抗凝药显示有保护作用.
- 传单血栓并没有与死亡率增加相关,但与中风风险增加有关,特别是伴随着传单运动减少时.
结论:
- 叶片血栓的患病率因成像方式,假肢类型和抗凝血状态而有显著差异.
- 叶片血栓症和/或叶片运动减少的诊断与脑血管事件的风险增加有关.
- 传单血栓本身似乎不会影响TAVR后的患者存活率.
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