跨导管大动脉植入和导电障碍:关注临床影响
Antonios Halapas1, Leonidas Koliastasis2, Ioannis Doundoulakis3,4
1Department of Interventional Cardiologist and THV Program, Athens Medical Center, 11526 Athens, Greece.
Journal of cardiovascular development and disease
|November 24, 2023
概括
过导管大动脉植入 (TAVI) 可能导致导电异常 (CA) 和起器 (PPM) 需求. 了解预测因素是管理TAVI患者的CA风险的关键.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心脏电生理学 心脏电生理学
背景情况:
- 过导管大动脉植入 (TAVI) 是严重大动脉狭窄的主要治疗方法,包括在低手术风险的个体.
- 导电异常 (CA) 和永久起器 (PPM) 植入是TAVI后的常见并发症,原因是大动脉根和心脏导电系统的接近.
- 新发病的左捆分支阻塞 (LBBB) 和高度心房阻塞是TAVI之后最常见的CA.
研究的目的:
- 审查通过导管大动脉植入 (TAVI) 的患者传导异常 (CA) 的发生率,预测因素,影响和管理.
- 强调考虑程序前和程序内因素的重要性,这些因素会导致TAVI后的CA和PPM要求.
- 为心脏团队提供最佳患者选择和管理的信息,特别是因为TAVI越来越多地用于年轻,寿命更长的人群.
主要方法:
- 关于导电异常和TAVI后心脏起器植入的当前文献的审查.
- 对影响TAVI后CA发展的解剖学,病理生理学和程序因素的分析.
- 综合有关TAVI患者中CA的发病率,预测因素,临床影响和管理策略的数据.
主要成果:
- 在TAVI后的PPM植入率是可变的,受患者特异性和程序因素的影响.
- 左束枝阻塞和高度心房阻塞是TAVI后常见的CA.
- 识别CA的预测因素对于风险分层和管理规划至关重要.
结论:
- 导电异常和需要永久起器是TAVI程序中的重要考虑因素.
- 程序前查和对风险因素的认识对于尽量减少TAVI后的CA至关重要.
- 有效的管理策略是必要的,以解决CA和优化TAVI患者的结果,特别是在扩大指示和年轻患者队列的背景下.
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