在SAPIEN 3之后重新TAVR可行性,根据植入物深度和commissural对齐进行分层:CT模拟研究
Anoop N Koshy1,2,3, Gilbert H L Tang1,4, Sahil Khera1
1The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York (A.N.K., G.H.L.T., S.K., M.V., M.B., S.G., A.H., L.S., S.L., G.D.D., S.K.S., A.S.K., P.K.).
Circulation. Cardiovascular interventions
|March 19, 2024
概括
用较浅的初始SAPIEN 3门植入物更换再通气管大动脉 (TAVR) 的可能性较低. 适当的植入深度和指导管对齐对于未来的冠状动脉接入和重复TAVR程序至关重要.
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
- 生物医学工程 生物医学工程
背景情况:
- 重复透气管大动脉置换 (TAVR) 可能会因为传单封存而危害冠状动脉通道.
- 最初的TAVR植入深度和 commissural对准对重复TAVR可行性的影响仍然不清楚.
研究的目的:
- 评估SAPIEN 3 (S3) TAVR之后的再TAVR和冠状动脉接入的可行性.
- 根据初始植入深度和 commissural 对齐来分层可行性.
主要方法:
- 利用多探测器计算机断层扫描来评估患者.
- 在不同的植入物深度进行S3 TAVR模拟.
- 使用特定的门到鼻管结和鼻腔高度标准评估重复TAVR的不可行性.
- 估计冠状动脉接入可行性基于新皮平面.
主要成果:
- 在较浅的初始S3植入深度下,重新TAVR的可行性显著下降 (2.3%与27.5%相比).
- 较大的S3尺寸降低了重复TAVR的可行性,特别是在100:0植入物中.
- 在所有情况下,通过修改传单的委员会调整,可以实现重复TAVR.
- 冠状动脉接入受到初始S3植入物深度和大小的影响.
结论:
- 植入物深度, commissural 对齐, 门大小 批判性地预测重复TAVR的可行性.
- 个性化程序前规划对于长期的再干预前景至关重要.
- 考虑到未来的干预措施至关重要,因为TAVR的使用在年轻人群中不断扩大.
相关概念视频
01:10Computed Tomography
Tomography refers to imaging by sections. Computed tomography (CT) is a non-invasive imaging technique that uses computers to analyze several cross-sectional X-rays to reveal minute details about structures in the body.
The technique was invented in the 1970s and is based on the principle that as X-rays pass through the body, they are absorbed or reflected at different levels. In the technique, a patient lies on a motorized platform while a computerized axial tomography (CAT) scanner rotates...
The technique was invented in the 1970s and is based on the principle that as X-rays pass through the body, they are absorbed or reflected at different levels. In the technique, a patient lies on a motorized platform while a computerized axial tomography (CAT) scanner rotates...
01:14Imaging Studies I: CT and MRI
Introduction: MRI and CT scans are crucial advancements in medical imaging techniques, playing a vital role in diagnosing conditions related to the gastrointestinal (GI) system. Each scan serves distinct purposes, targets specific areas, and requires unique nursing duties.
Description of the Procedures
Computed Tomography (CT) scan:
Computed Tomography (CT) scans use X-ray technology to generate detailed images of bones, organs, and tissues. During the scan, the patient lies on a moving table...
Description of the Procedures
Computed Tomography (CT) scan:
Computed Tomography (CT) scans use X-ray technology to generate detailed images of bones, organs, and tissues. During the scan, the patient lies on a moving table...
01:28Imaging Studies for Cardiovascular System V: CT
Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...
01:27Imaging Studies III: Computed Tomography
DefinitionComputed Tomography (CT) of the genitourinary (GU) tract is a non-invasive imaging modality that utilizes X-rays and computer processing to generate detailed cross-sectional images of the urinary system, encompassing the kidneys, ureters, bladder, and adjacent structures such as the adrenal glands.PurposeCT scans of the GU tract serve several diagnostic and therapeutic purposes, including:Diagnosis of Urinary Tract Diseases: Detects kidney stones, tumors, cysts, and congenital...