气球大动脉膜整形与或没有皮肤冠状动脉干预在跨导管大动脉置换时代的气球大动脉膜整形
Omar Aldalati1,2, Matthew Jackson1, Seth Vijayan1
1Cardiothoracic Department, The James Cook University Hospital, Middlesbrough, UK.
Cardiology
|March 25, 2024
概括
气球大动脉膜整形术和穿皮冠状动脉干预 (BAV-PCI) 的联合治疗对于患有大动脉狭窄的高风险患者来说是安全的和可行的. 结果与单独使用BAV相比,死亡率没有显著差异.
科学领域:
- 干预心脏病学 干预心脏病学
- 心血管医学 心血管医学
- 结构性心脏病是一种心脏病.
背景情况:
- 气球大动脉膜整形 (BAV) 仍然是大动脉狭窄 (AS) 的一个有争议的选择,在跨导管大动脉置换 (TAVR) 时代.
- 结合BAV与穿皮冠状动脉干预 (PCI) 的安全性和可行性尚未得到充分证实.
研究的目的:
- 评估联合BAV和PCI (BAV-PCI) 的安全性和可行性.
- 为了比较在接受BAV的患者的手术结果和死亡率,同时进行PCI或不进行PCI.
主要方法:
- 在2009年11月至2020年7月接受BAV的264名患者的回顾性研究.
- 患者被分为三个组:联合BAV-PCI (A组),BAV与非再血管化的CAD (B组),和BAV没有显著的CAD (C组).
- 在不同组中对手术并发症 (VARC-3标准) 和30天/一年死亡率进行了比较.
主要成果:
- 在三组中,VARC-3判断的并发症没有显著差异 (11%对13%对5%,p=0.168).
- 整体30天和一年的死亡率分别为9.8%和32%,两组之间没有统计学上显著的差异.
- 单变量分析表明,与A组 (BAV-PCI) (HR 1.58,p=0.010) 相比,B组 (BAV与非再血管化的CAD) 的死亡风险更高.
- 多变量分析确定了STS得分,心脏性休克,呈现模式和缺乏明确的门干预作为死亡率预测因素.
结论:
- 联合BAV-PCI是一种安全且可行的策略,用于患有大动脉狭窄症的高风险患者.
- 这种程序与与BAV相比的结果相关,该程序与或没有显著的冠状动脉疾病进行.
- 死亡率的关键预测因素包括STS得分,心脏性休克,表现,以及随后没有明确的门干预.
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