从CoreValve扩展使用跨导管大动脉到手术大动脉研究的五年随访
Tanvir K Bajwa1, Roger J Laham2, Kamal Khabbaz2
1XXX, Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Milwaukee, Wisconsin.
在失败的外科门 (TAV-in-SAV) 中,透气管大动脉置换 (TAVR) 是极端风险患者的安全选择. 五年终点显示稳定的临床和血液动力学结果,严重的膜回率低.
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:
- 超导管大动脉置换 (TAVR) 为极度风险的患者提供了替代方案,需要在未成功的手术大动脉生物假体中进行重新手术.
- 对TAV-in-SAV程序的长期数据有限,需要进一步调查其耐用性和安全性.
研究的目的:
- 用CoreValve扩展使用研究来评估TAV-in-SAV的5年结果.
- 根据手术性大动脉衰竭的模式 (缩小,吐或结合) 分析结果.
主要方法:
- 在CoreValve扩展使用研究中,招募了226名接受TAV-in-SAV的极端风险患者.
- 结果在5年后进行评估,分层按手术大动脉故障模式进行分层.
- 研究地点报告了心声数据.
主要成果:
- 五年全因死亡率或重大中风率为47.2%.
- 严重假肢与患者不匹配的患者的死亡率更高 (51.7%vs38.3%).
- 5年后,大动脉的整体再干预率为5.9%,血液动力学功能稳定,并出现极小的严重膜回.
结论:
- 带有超环状,自我扩张的TAVR装置的TAV-in-SAV对于具有适当尺寸的失败手术的极度风险患者来说是一种安全和持久的选择.
- 临床和血液动力学结果在治疗后5年内保持稳定.
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