由于动态左心室阻塞,经过导管大动脉置换后急性血液动力学损害:系统性审查
Diego Barzallo1, Juan Torrado2, Cesar Joel Benites-Moya1
1Department of Internal Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, New York.
The American journal of cardiology
|December 16, 2023
概括
过导管大动脉置换 (TAVR) 后的急性血液动力学损害,称为左心室阻塞 (LVO),主要影响女性. 在TAVR前的心声回声学对于识别有风险的患者至关重要,特别是那些患有LV外流通道阻塞的患者.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心脏外科手术 心脏外科手术
背景情况:
- 由于动态左心室阻塞 (LVO) 的急性血液动力学损害,或自杀LV,是经过透气管大动脉置换 (TAVR) 后的罕见但严重的并发症.
- 以前的研究对这种并发症的定义很差,阻碍了及时诊断和有效治疗.
研究的目的:
- 系统地审查和定义由动态LVO引起的TAVR后的急性血液动力学损害.
- 为了确定患者的特征,临床表现,以及最佳的管理策略,为这种并发症.
主要方法:
- 使用PubMed,Embase,Web of Science和Medline进行了系统的文献审查.
- 从506项初步研究中,在两位作者进行单独审查后,选出了25篇符合条件的出版物.
主要成果:
- 大多数经历TAVR后LVO的患者是具有特定心声回声学发现的女性 (过度缩小隔膜,小心室,超动态收缩性).
- 显著的低血压是主要的表现,通常发生在门部署后立即,左心室外流通道是最常见的阻塞部位.
- 近65%的病例需要先进疗法.
结论:
- 从TAVR后动态LVO引起的急性血液动力学损害主要发生在女性身上.
- 在TAVR前进行心声回声扫描对于预测这种并发症至关重要,特别是在涉及左心室外流通道阻塞的情况下.
- 应在耐火性血液动力学崩的早期考虑先进疗法.
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