伴心透管边缘到边缘维修量和趋势
Kris Kumar1,2, Timothy F Simpson1, Harsh Golwala1
1Knight Cardiovascular Institute, Oregon Health and Science University, Portland, OR, USA.
Journal of interventional cardiology
|December 27, 2023
概括
跨导管端到端修复 (TEER) 的使用在2015-2019年期间在医疗保险患者中显著增加. 运营商的程序量也增长了,但TEER使用的地理差异仍然存在.
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
- 医疗保健服务研究 医疗服务研究
背景情况:
- 操作人员的经验与跨导管边缘到边缘修复 (TEER) 的程序成功有关.
- 对于TEER的当代利用和程序量仍然不完全理解.
- 了解趋势对于优化患者的治疗结果和获得护理的机会至关重要.
研究的目的:
- 为了确定TEER的年度运营商程序量.
- 分析TEER利用的时间趋势.
- 为了检查美国医疗保险患者中TEER的地理变异性.
主要方法:
- 使用了国家医疗保险提供者利用和支付数据库.
- 从2015年到2019年分析了CPT代码33418 (MitraClip) 的数据.
- 评估年度经营者程序量,发生率和纵向/地理趋势.
主要成果:
- 在2015-2019年期间,进行了27,034次TEER手术.
- 全国范围内的TEER发病率上升了283% (每10万患者中的6.2到23.8).
- 在TEER发病率 (每10万人中5.5至54.9) 和平均年度操作员数量 (2019年为9.1例) 中,观察到显著的州级变化.
结论:
- 从2015年到2019年,TEER的使用量和运营商程序量显著增加.
- 美国各州在TEER利用方面存在相当大的地理差异.
- 需要进一步的研究,以了解这种变化的临床影响,并确定最佳的手术体积,以提高疗效和获取.
相关概念视频
Conservation of Mass in Finite Cotrol Volume
The principle of conservation of mass is a fundamental law in fluid mechanics and is applied using the continuity equation. We apply the concept to a finite control volume to derive the continuity equation.
A system is defined as a collection of unchanging contents, and the conservation of mass states that a system's mass is constant.
A system is defined as a collection of unchanging contents, and the conservation of mass states that a system's mass is constant.
Conservation of Mass in Fixed, Nondeforming Control Volume
The principle of conservation of mass is fundamental in fluid dynamics and is crucial for analyzing flow within fixed control volumes, such as pipes or ducts. This principle states that the total mass within a control volume remains constant unless altered by the inflow or outflow of mass through the control surfaces. This results in a vital relationship for steady, incompressible flow where the mass entering a system equals the mass leaving it.
In the case of a sewer pipe, which can be modeled...
In the case of a sewer pipe, which can be modeled...
Application of the Linear Momentum Equation
The application of the linear momentum equation can be used to analyze the forces needed to hold a 180-degree pipe bend in place with flowing water. In this case, water flows through the bend with a constant cross-sectional area of 0.01 square meters and a flow velocity of 15 meters per second. The pressure at the entrance is 0.2 Megapascals and the pressure at the exit is 0.16 Megapascals.
The goal is to determine the force components in the x and y directions to hold the pipe in place. Since...
The goal is to determine the force components in the x and y directions to hold the pipe in place. Since...
Major Losses in Pipes
When a fluid flows through a pipe, it experiences energy losses due to frictional resistance along the pipe walls, known as major losses. These energy losses result in a pressure drop, which varies based on the flow conditions — whether laminar or turbulent — and the specific physical properties of the fluid and pipe.
Fluid flow can be classified as laminar or turbulent, primarily based on the Reynolds number. This dimensionless number reflects the relative influence of inertial to viscous...
Fluid flow can be classified as laminar or turbulent, primarily based on the Reynolds number. This dimensionless number reflects the relative influence of inertial to viscous...
Minor Losses in Pipes
In pipe systems, minor losses refer to energy losses arising from components such as valves, bends, fittings, expansions, and other features that disrupt the steady flow of fluid. These disturbances cause energy dissipation through turbulence and resistance, which engineers quantify to manage system efficiency effectively.
Valves play a significant role in generating minor losses by obstructing or redirecting the fluid flow. When a valve is closed or partially closed, it restricts the flow...
Valves play a significant role in generating minor losses by obstructing or redirecting the fluid flow. When a valve is closed or partially closed, it restricts the flow...
Pipe Flowrate Measurement
In pipe flow measurement, orifice, nozzle, and Venturi meters are commonly used to determine fluid flowrates by constricting the flow area, which increases fluid velocity and reduces pressure. This pressure difference, governed by Bernoulli's principle and adjusted for real-world conditions, is essential for calculating flowrate. Each meter type is suited to specific applications based on accuracy, efficiency, and compatibility with various flow conditions.
The orifice meter is a simple,...
The orifice meter is a simple,...


