跨导管边缘到边缘的中枢门修复与最小侵入性中枢门手术:一项观察性研究
Miriam Silaschi1, Franca Cattelaens1, Hossien Alirezaei1
1Department of Cardiac Surgery, Heart Center Bonn, 53127 Bonn, Germany.
Journal of clinical medicine
|April 9, 2024
概括
额头管穿透管边缘到边缘修复 (M-TEER) 最初显示的生存率低于微创手术,但在匹配后的结果均等. M-TEER在减少额头吐方面效果较差,导致梯度更高.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心脏外科手术 心脏外科手术
背景情况:
- 最少侵入性 mitrale 手术 (MIC-MVS) 是标准的 mitrale 吐 (MR).
- 两透管端到端修复 (M-TEER) 用于高风险患者,并越来越多地用于中等风险患者.
- 在M-TEER和MIC-MVS队列之间存在显著的基线差异.
研究的目的:
- 为了比较M-TEER和MIC-MVS的结果.
- 为了评估存活率,MR减小,以及两种手术之间的中枢梯度.
- 评估患者匹配对比结果的影响.
主要方法:
- 对723个M-TEER和123个MIC-MVS程序 (2010-2021) 的回顾性分析.
- 使用基于年龄,LVEF,EuroSCORE II和MR病因学的匹配对进行敏感性分析.
- 一年生存率的比较,释放时的MR等级,以及手术后的 mitra 梯度.
主要成果:
- M-TEER患者年龄较大,手术风险较高 (EuroSCORE II) 和LVEF较低.
- 在M-TEER (91.5%) 和MIC-MVS (97.6%) 中,一年生存率较低,p=0.04.
- 在M-TEER (24.5%中度/重度MR) 和MIC-MVS (6.5%) 中,MR的减少效果较差,p<0.01.
- 匹配分析显示,M-TEER (4.1 mmHg) 与MIC-MVS (3.4 mmHg) 的生存率相似,但中枢梯度较高,p=0.04.
结论:
- 与MIC-MVS相比,M-TEER的初始较低生存率通过匹配而得到缓解.
- M-TEER 显示了较不有效的 MR 减少和更高的术后 mitra 梯度.
- 这些发现突显了M-TEER和MIC-MVS之间的权衡,特别是在中等风险患者中.
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