混合性大动脉膜疾病:与膜泄漏有关,在经过透气管大动脉膜置换后的存活率降低
Caglayan Demirel1, Max Paul Winter1, Christian Nitsche1
1Department of Internal Medicine II, Clinical Division of Cardiology, Medical University of Vienna, Waehringer Guertel 18-20A, 1090 Vienna, Austria.
European heart journal. Cardiovascular Imaging
|January 18, 2024
概括
混合性大动脉病 (MAVD) 在过导管大动脉置换 (TAVR) 患者中很常见,增加了对膜回 (PVR) 的风险和更糟糕的长期存活率. 早期干预可以改善TAVR接受MAVD患者的结果.
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:
- 过导管大动脉置换 (TAVR) 已经改变了严重的大动脉狭窄 (AS) 的治疗方法.
- 混合性大动脉病 (MAVD) 代表了接受TAVR的复杂患者亚组,长期结局数据有限.
- 了解MAVD对TAVR结果的影响对于患者管理至关重要.
研究的目的:
- 为了确定在接受TAVR的患者中MAVD的患病率.
- 为了调查MAVD和TAVR后的垂回 (PVR) 之间的关联.
- 分析MAVD对TAVR后长期死亡率的影响.
主要方法:
- 一个基于注册表的队列研究,使用维也纳TAVR注册表 (2007年1月 - 2020年5月).
- 包括880名具有TAVR前和后可用的跨胸部心声回声仪的患者.
- 对PVR发病率和长期生存结果的分析.
主要成果:
- 在73.52%的TAVR患者中发现了MAVD.
- MAVD与PVR显著相关 (OR2.06,P<0.001).MAVD与PVR显著相关 (OR2.06,P<0.001).MAVD与PVR显著相关 (OR2.06,P<0.001).MAVD与PVR显著相关 (OR2.06,P<0.001).
- 在TAVR后的轻度PVR与较高的死亡率相关 (HR 1.33,P = 0.016),PVR后的MAVD (HR 1.30,P = 0.022).
结论:
- 在TAVR患者中,MAVD很普遍,与PVR风险增加和较差的长期结果相关,与孤立的AS相比.
- 在MAVD患者中,无论TAVR后的PVR状态如何,长期生存都受到损害.
- 早期干预或手术门置换可能有助于改善MAVD患者的治疗结果.
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