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跨导管大动脉置换中的演变范式:来自高容量单中心体验的结果

Giulia Costa¹, Cristina Giannini¹, Matteo Mazzola¹

¹Cardiac Thoracic and Vascular Department, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.

The American journal of cardiology

|November 30, 2023

概括

过导管大动脉置换 (TAVR) 程序越来越简单,越来越成功. 精简的TAVR方法,包括使用冠状动脉计算机断层扫描血管学 (CCTA),改善患者的生存率.

科学领域:

心脏病学心脏病学
干预心脏病学干预心脏病学
医疗器械技术医疗器械技术

背景情况:

透气管大动脉置换 (TAVR) 指示正在扩展到年轻,风险较低的患者.
简化和精简TAVR程序对于更广泛的采用和更好的结果至关重要.

研究的目的:

评估程序简化对TAVR结果的影响.
评估冠状动脉计算机断层扫描血管学 (CCTA) 作为手术前规划工具的安全性和有效性.

主要方法:

预计将在2015年至2020年期间招募771名接受TAVR治疗的患者.
将患者划分为时间三角形,以分析程序方法和结果的趋势.
术前规划的比较 (CCTA与冠状动脉血管学),手术技巧和临床结果.

主要成果:

设备立即成功率显著增加,随着时间的推移,住院时间减少.
在CCTA的广泛采用 (大约. 60%) 没有报告的不良事件.
与简化TAVR方法相关的1年生存率的提高.

结论:

TAVR程序表现出一贯的趋势,即精简,提高成功率和更好的1年结果.
一个基于CCTA的策略安全地减少了手术前侵入性冠状动脉血管造影的需要.
功能能力低下,CAD,功能障碍,输血和PVL等因素与较差的结果有关.

关键词:

大动脉狭窄症 (大动脉狭窄)多切片计算机断层扫描血管图谱通过导管更换大动脉门.

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