对于严重的 mitra 吐,COMBO 治疗的结果与跨导管边缘到边缘修复相比较
Hiroaki Yokoyama1,2, Tobias Friedrich Ruf2, Theresa Ann Maria Gößler2
1Department of Cardiology and Catheterization Laboratories, Shonan Kamakura General Hospital, Kamakura, Japan.
Frontiers in cardiovascular medicine
|March 12, 2024
概括
对于严重的额头管反 (MR),同时进行的组合疗法 (COMBO) 显示出与单独进行的额头管横管端到端修复 (M-TEER) 相似的长期存活率. 然而,COMBO疗法需要更多的重新干预,这表明它可能有利于患有更晚期心脏病的患者.
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
- 医疗器械技术 医疗器械技术
背景情况:
- 过导管 mitra 门修复 (TMVr) 涵盖了各种技术,如传单近似,环状结合和弦管器官修复.
- 同时的组合疗法 (COMBO),合并与其他TMVr方法的交叉管边缘修复 (M-TEER),对于严重的交叉管吐 (MR) 是可行的.
- 在此之前,对于严重的MR结局,COMBO疗法和单独使用M-TEER之间的直接比较缺乏.
研究的目的:
- 为了比较COMBO疗法与单独M-TEER治疗在患有严重MR的患者中的程序和临床结果.
- 评估TMVr综合方法对患者结果和再干预率的影响.
主要方法:
- 在2015年3月至2018年4月期间,对357名连续接受COMBO或M-TEER治疗的患者进行了回顾性分析.
- 排除标准包括先前的 mitra 门手术或重复手术.
- 在COMBO和M-TEER组之间比较了程序结果和全因死亡率.
主要成果:
- 康博组的患者呈现出更大的左心室大小,左下心室喷射率 (LVEF) 和更严重的MR.
- 两组之间的残留MR (≥2+) 没有显著差异.
- 康博组经历了更高的重复干预率,主要使用M-TEER,尽管在3.6年的随访期间,所有原因的死亡率没有显著差异.
结论:
- 复合疗法可能是一个可行的选择,严重的MR患者有显著的左心室扩张和功能障碍.
- 在COMBO组中,重新干预的需求增加可能表明更复杂的解剖学和早期干预的潜在益处.
- 需要进一步的研究来确定COMBO疗法作为一种多功能,针对患者的治疗策略,用于各种MR解剖学和病理学.
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