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尽管面临挑战,右侧横轴横导管大动脉替换与左侧大动脉替换相当

Daniel McGrath¹, Hansuh Lee¹, Charley Sun¹

¹Tufts University School of Medicine, Boston, MA, USA.

General thoracic and cardiovascular surgery

|March 9, 2024

概括

右侧横透管大动脉置换 (TAVR) 的结果与左侧通道相比,即使存在解剖学上的挑战. 一种新的"flip-n-flex"技术提高了手术效率,并减少了对右关节TAVR的起器需求.

科学领域:

心血管外科心血管外科
干预心脏病学干预心脏病学
医疗器械医疗器械

背景情况:

交叉门接入是一种常见的替代方法,用于跨导管大动脉置换 (TAVR) 的输血门接入.
典型的偏好是左侧交叉门,但右侧交叉门由于对立的动脉和大动脉曲线而存在解剖学上的挑战.
程序修改可能是必要的,以优化对准和对右交叉轴心TAVR的结果.

研究的目的:

为了在单个中心比较左侧和右侧交叉关TAVR之间的结果.
评估程序修改的有效性,特别是"翻转-n-flex"技术,以促进正确的TAVR交易.

主要方法:

使用SAPIEN 3门 (2016年6月 - 2022年6月) 连续使用左侧或右侧巴TAVR手术的患者特征和结果的回顾性比较.
对右骨组的子分析,以评估"翻转-n-flex"技术对程序效率和新传导干扰的影响.

主要成果:

进行了25次右侧和26次左侧交叉关TAVR. 两组之间没有观察到患者特征或整体结果的显著差异.
在右下组中",翻转-n-flex"技术 (用于18名患者) 与显著缩短的光镜时间 (21.2 ± 6.2分 vs 29.6 ± 12.4分,p=0.03) 相关.
与没有该技术的病例相比",翻转-n-flex"技术也显示出减少永久心脏起器植入的趋势 (6.3%与42.9%,p=0.07).

结论:

尽管存在潜在的解剖学困难,但右侧关节TAVR显示了与左侧关节接入相似的结果.
"翻转-n-flex"技术提高了右交叉轴TAVR的可行性和效率,使其成为有限访问选择的患者的有吸引力的选择.

关键词:

另类接入方式其他接入方式光镜检测是一种光学检测.起器是一种心脏起器.这是一笔交易式的交易.通过导管更换大动脉门.

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