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门内透导管大动脉门和 mitra 门更换后的最佳抗血栓策略

Maximilian Reisinger¹, Polydoros N Kampaktsis², Tanush Gupta³

¹Division of Cardiac, Thoracic & Vascular Surgery, New York-Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA.

Journal of thoracic disease

|March 20, 2024

概括

生物假体心脏膜衰竭需要重新干预. 门内程序提供了一个替代方案,但这些患者的最佳抗血栓治疗仍然不清楚,需要进一步研究.

科学领域:

心脏病学心脏病学
干预心脏病学干预心脏病学
生物材料科学生物材料科学

背景情况:

生物假体心脏门的使用越来越多,但其耐用性有限,导致对重新干预的需求越来越大.
手术修复/更换是失败的生物假体的标准,但对于高风险患者,内 (ViV) 过导管程序正在出现.

研究的目的:

为了回顾目前对术后抗血栓治疗的理解,在门内 (ViV) 跨导管大动脉和 mitra 门置换后.
突出挑战和需要基于证据的指导方针,关于这种患者群体的抗血栓治疗策略.

主要方法:

审查现有的文献和指导方针在心脏门置换后对抗血栓治疗.
分析影响抗血栓选择的因素,包括患者的并发症和膜特征.

主要成果:

ViV手术带有大量的血栓栓塞事件和膜血栓形成的风险,往往高于本源置换.
目前的指导方针缺乏ViV抗血栓治疗的具体方案.
口服抗凝剂 (例如VKA) 经常使用,并且在减少血栓形成方面表现出有效性,与原生TAVR的标准抗血小板治疗不同.

结论:

在ViV手术后最佳的抗血栓治疗尚未确定.
考虑患者特异性因素,膜血液动力学和故障膜特征至关重要.
前性研究对于建立基于证据的抗血栓策略对于ViV跨导管大动脉和中枢置换至关重要.

关键词:

透过导管的大动脉替换 (TAVR)抗血栓治疗是一种抗血栓治疗.生物假肢大动脉 (BAV)透气管中枢替换 (TMVR) 的方法门中的门 (ViV)

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