透导管与手术修复 mitra 在患有 mitra 吐的患者中
Monil Majmundar1, Kunal Nitinkumar Patel2, Rajkumar Doshi3
1Department of Cardiovascular Medicine, University of Kansas Medical Center, Kansas City, KS, USA.
概括
透导管 mitra 门修复 (TMVr) 在初级 mitra 反和心力衰竭患者中比手术修复 (SMVr) 具有更高的中期风险. 对TMVr来说,共享决策至关重要,与SMVr相比,权衡好处与风险.
科学领域:
- 心血管医学 心血管医学
- 干预心脏病学 干预心脏病学
- 心脏门疾病 心脏门疾病
背景情况:
- 副心脏反 (MR) 是一种常见的膜性心脏病.
- 减少喷射分数 (HFrEF) 的心力衰竭通常与MR共存.
- 过导管 mitra 门修复 (TMVr) 为外科手术 mitra 门修复 (SMVr) 提供了一种不那么侵入性的替代方案.
研究的目的:
- 为了比较TMVr与SMVr的临床结果.
- 在初级MR患者中评估TMVr和SMVr.
- 在MR和HFrEF患者中评估TMVr和SMVr.
主要方法:
- 使用全国再接收数据库 (2016-2019) 进行回顾性队列研究.
- 在接受TMVr或SMVr的患者中, 1:1的倾向性得分匹配.
- 主要结局:主要心血管不良事件 (MACE) 的组合;次要结局:住院死亡率.
主要成果:
- 主要MR的匹配对为2187,MR-HFrEF的匹配对为2178.
- 在两个队列中,TMVr的中期MACE显著高于SMVr (初级MR HR 1.73;MR-HFrEF HR 2.00).
- 在两组中,TMVr和SMVr之间的住院死亡率相似.
结论:
- 与SMVr相比,TMVr在初级MR和MR-HFrEF中具有更高的中期MACE.
- 虽然TMVr可能会带来短期的好处,但SMVr在中期表现出更好的结果.
- 分享决策对于讨论TMVr风险和好处与SMVr资格至关重要.
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