在心脏计算机断层扫描中,心室间隔膜厚度作为在接受过导管大动脉置换手术的患者中传导障碍的新型风险因素
Nili Schamroth Pravda1,2, Yonatan Shaleve2,3, Ygal Plakht4
1Department of Cardiology, Rabin Medical Center, 39 Jabotinsky Street, Petach Tikva 49414, Israel.
概括
在手术前的计算机断层扫描 (CT) 可以评估基底室间隔膜 (IVS) 厚度,以预测跨导管大动脉置换 (TAVR) 后的导电障碍. 较薄的IVS测量表明这些术后并发症的风险更高.
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
- 干预心脏病学 干预心脏病学
背景情况:
- 腹腔间隔膜 (IVS) 对心脏电导极为重要.
- 导电障碍是经过过导管大动脉置换 (TAVR) 后的一个已知的风险.
- 准确的手术前对TAVR并发症的风险评估至关重要.
研究的目的:
- 为了确定基底室间隔膜 (IVS) 厚度是否通过手术前计算机断层扫描 (CT) 测量,可以预测TAVR后的导电障碍.
- 调查IVS厚度作为潜在的解剖保护屏障的作用.
主要方法:
- 包括78名患有严重大动脉狭窄并接受TAVR治疗的患者.
- 术前CT扫描用于测量膜隔膜 (MS) 下多个层次的基础IVS厚度.
- 主要终点是TAVR后传导干扰的复合.
主要成果:
- 导电障碍发生在30.8%的患者中.
- 与没有传导障碍的患者相比,在所有测试水平上,IVS测量显著较薄.
- 在程序前的IVS厚度小于4毫米,在MS独立预测的TAVR后传导干扰 (adjOR 7.387) 下2毫米处,小于4毫米.
结论:
- 基底IVS厚度的手术前CT评估是一种用于预测TAVR后传导障碍的新标记.
- 在TAVR过程中,IVS厚度可以作为解剖障碍,保护导电系统免受机械应力.
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