过导管关闭或手术症状的膜漏洞:多中心KISS注册表
Ahmet Güner1, Cevat Kırma2, Mehmet Ertürk1
1Department of Cardiology Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital Istanbul Turkey.
Journal of the American Heart Association
|December 29, 2023
概括
与手术相比,对于有症状的副膜泄漏 (PVL) 的横导管关闭 (TC) 显示了较低的早期死亡率和类似的长期存活率. 这项大型研究支持TC作为PVL治疗的有利选择.
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
- 心脏外科手术 心脏外科手术
背景情况:
- 有症状的膜漏洞 (PVL) 治疗选择,透导管关闭 (TC) 和手术,缺乏明确的最佳策略.
- 需要大规模的回顾性研究来比较TC和PVL手术重新手术之间的长期结果.
研究的目的:
- 为了回顾评估和比较跨导管关闭 (TC) 与对症状性膜漏洞 (PVLs) 的手术重新手术的长期结果.
- 评估TC和PVL手术治疗之间的住院和长期死亡率的差异.
主要方法:
- 在2002年至2021年期间,在三家高等医疗中心对335名PVL患者进行了回顾性分析.
- 患者被分为两组:透导管关闭 (TC) (n=171) 和手术重新操作 (n=164).
- 逆概率权重被用于调整回归模型中的治疗选择偏差. 主要终点是全因死亡.
主要成果:
- 在TC和手术组之间,技术和程序成功率相似.
- 手术组的住院死亡率 (15.9%) 与TC组 (4.7%) 相比显著更高 (调整后OR,4.55;P<0.001).
- 在手术和TC组之间,长期死亡率没有显著差异 (调整HR,1.11;P=0.679).
结论:
- 通过皮肤透过导管关闭膜漏洞与较低的早期死亡率有关.
- 与PVL的手术重新手术相比,透导管关闭显示出可比的长期死亡率.
- 这些发现表明,通过导管关闭可能是管理症状PVL的有利选择.
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