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低手术风险患者的透管大动脉置换:对延长后续随机对照试验的更新后分析

Gianluca Di Pietro¹, Riccardo Improta¹, Ovidio De Filippo²

¹Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Umberto I Hospital, Sapienza University of Rome, Italy; Department of Medical Science, Division of Cardiology, Molinette Hospital, Turin University, Italy.

The American journal of cardiology

|May 10, 2024

概括

在低风险患者中,透管大动脉置换 (TAVR) 显示出与外科大动脉置换 (SAVR) 相似的长期安全性和有效性. TAVR具有较高的准膜泄漏风险,但心房动率较低.

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:

过导管的大动脉置换 (TAVR) 和外科大动脉置换 (SAVR) 是大动脉狭窄的关键治疗方法.
在低风险患者中,TAVR与SAVR的长期比较数据有限.
需要进行聚合分析来评估长期的安全性和有效性.

研究的目的:

为了比较TAVR与SAVR在低手术风险患者的长期安全性和有效性.
分析包括死亡率,中风,心血管事件和程序并发症在内的结果.
评估心声回声学参数和重新干预率.

主要方法:

一个系统的电子数据库搜索确定了随机对照试验 (RCT).
包括的试验包括低手术风险的患者 (STS得分<4%),随访时间长达5年.
使用随机效应模型计算各种结果的几率比率 (OR) 和95%置信区间 (CI).

主要成果:

与SAVR相比,TAVR显示出与SAVR相似的全因死亡率和致残性中风率.
在主要心血管事件,心肌梗塞,膜血栓形成,内心炎,重新干预或再住院方面没有发现显著差异.
TAVR显示了较高的准膜泄漏风险,但较低的新发动心房动率;永久心脏起器植入率是可比的.

结论:

在低风险患者中,TAVR的长期安全性和有效性与SAVR相美.
关键差异包括TAVR增加了对膜漏洞的风险,SAVR增加了心房动率.
此外,TAVR还导致了更大的有效孔面积,这表明门功能得到了改善.

关键词:

长期的长期的长期的手术风险较低的手术风险.进行元分析.结果的结果.这就是SAVR的原因.在TAVRR中,我们可以看到.

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