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在TAVR之后使用自扩展装置进行冠状动脉管:RE-ACCESS 2研究

Giuliano Costa¹, Sofia Sammartino¹, Orazio Strazzieri¹

¹Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco," Catania, Italy.

JACC. Cardiovascular interventions

|March 8, 2024

概括

在用自扩张门进行透气管大动脉门置换 (TAVR) 后,5.5%的患者出现了不成功的冠状动脉管. 接受Evolut THV的患者遇到更多问题,特别是与右冠状动脉管道连接的问题,这与错位有关.

科学领域:

心脏病学心脏病学
干预心脏病学干预心脏病学
医疗器械医疗器械

背景情况:

通过自扩张的跨导管心脏 (THVs) 植入辅管对齐 (CA) 进行过横导管主动脉置换 (TAVR) 后的冠状动脉重新投入是研究不足的.
了解TAVR后冠状动脉接入的挑战对于患者的治疗结果至关重要.

研究的目的:

评估使用CA技术植入自扩展THV的TAVR后冠状动脉管不成功的率.
为了确定 TAVR.后失败的选择性冠状动脉骨重新参与的预测因素.

主要方法:

一个前性,单中心研究 (RE-ACCESS 2) 连续的TAVR患者接受通过CA植入的Evolut或ACURATETHVs.
主要终点:TAVR后冠状动脉管治疗失败.
二级终点:通过CT血管造影的冠状动脉骨重新参与失败的术后预测因素.

主要成果:

在127名患者中,5.5%的患者出现了不成功的冠状动脉通道,主要是Evolut THVs (7.5%对2.3%).
与Evolut THVs (6.3%与0.0%) 相比,右冠状动脉通道失效更常见.
冠状动脉重叠预测了右冠状动脉通道失效 (OR:5.6),严重的Evolut THV错位预测了整体冠状动脉通道失效 (OR:24.7).

结论:

不成功的冠状动脉管影响5.5%的TAVR病例使用自扩展THV与CA,EvolutTHV显示较高的发病率.
圆心错位是TAVR后冠状动脉管治疗影响的重要因素,特别是在Evolut THV接受者中.

关键词:

在这里,我们可以看到CAD,CAD,CAD.在TAVRR中,我们可以看到.长的对齐是指长的对齐.冠状动脉管是指冠状动脉管.

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