通过导管或外科动脉置换在低或中等外科风险的小 Annuli 的妇女
Thomas Modine1, John K Forrest2, Nicolas M Van Mieghem3
1Department of Cardiac Surgery, Cardiologique de Haut Lévèque - (CHU) de Bordeaux, France.
The American journal of cardiology
|April 19, 2024
概括
过导管大动脉置换 (TAVR) 和手术对患有小大动脉环形的女性显示了类似的2年结果. TAVR提供了更好的血液动力学,而手术导致了更少的起器.
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
- 心脏外科手术 心脏外科手术
背景情况:
- 有限的随机数据存在于通过导管的大动脉置换 (TAVR) 与在患有大动脉狭窄和小大动脉环形的妇女手术.
- 大动脉狭窄是一个重要的健康问题,特别是在老年人群中.
研究的目的:
- 为了评估TAVR的2年临床和血液动力学结果,与小主动脉环形女性的外科主动脉置换相比.
- 在这个特定的患者群体中评估急性门性能和早期/中期临床结果.
主要方法:
- 从Evolut低风险和SURTAVI试验中对女性进行的后期分析.
- 包括患有严重大动脉狭窄,低/中等手术风险,环形周长≤72.3毫米的妇女.
- 与手术性大动脉置换 (n=297) 进行比较的自我扩张的,超状TAVR (n=323) .
主要成果:
- 2年后,所有原因的死亡率或致残性中风没有显著差异 (6.5%的TAVR与8.0%的手术相比,p=0.47).
- 与手术 (8.3%,p<0.001) 相比,TAVR (20.0%) 的心脏起器率更高.
- TAVR显示出优越的血液动力学:更大的有效孔径面积 (1.9vs1.6cm2,p<0.001) 和较低的梯度 (8.0vs12.7mmHg,p<0.001).
- 较少的患者-假肢不匹配与TAVR (10.9%) 与手术 (33.2%,p<0.001).
结论:
- 在患有小主动脉环形的女性中,自我扩张的,超环形TAVR和手术产生了类似的2年临床结果.
- TAVR显示出改善了血液动力学性能,并减少了患者与假肢的不匹配.
- 手术性大动脉置换与心脏起器植入率较低有关.
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