通过导管更换大动脉门用于大动脉吐:一个系统的审查和元分析
Ran Liu1, Zhaolin Fu1, Zhengming Jiang1
1Department of Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital Affiliated to Capital Medical University, Beijing, China.
ESC heart failure
|May 15, 2024
概括
新一代用于严重大动脉反的设备的成功率很高. 标签上的设备在跨导管大动脉置换手术中,与标签外的设备相比,显示出更高的安全性和有效性.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 干预心脏病学 干预心脏病学
背景情况:
- 严重的大动脉反 (AR) 管理通常依赖于新一代设备 (NGD) 的有限数据.
- 现有关于AR中NGD的证据主要来自小患者队列的单臂研究.
- 需要对"标签上"与"标签外"NGD使用进行比较分析,以澄清安全性和有效性概况.
研究的目的:
- 系统地审查和综合当前关于NGDs严重AR的证据.
- 为了比较"标签上"和"非标签"NGD的安全性和有效性结果.
- 为了评估设备的成功,死亡率,心脏起器植入,并对膜泄漏率.
主要方法:
- 在主要数据库 (MEDLINE,Embase,Cochrane图书馆,Scopus) 进行了全面的文献搜索.
- 包括报道了针对AR进行过导管大动脉置换 (TAVR) 的研究.
- 分析了31项研究的数据,其中包括到2023年4月治疗的1851名患者.
主要成果:
- 30天后设备的整体成功率为94.5%. "标签上"的设备取得了97.8%的成功,而"标签外"的成功率为89.9% (P < 0.001).
- 所有原因的死亡率为4.2% (2.6%"在标签上"与5.1%"在标签之外",P = 0.006).
- "标签上"的设备显示永久心脏起器植入率显著降低 (6.9%与18.4%,P<0.001) 和超过轻微的准膜泄漏 (0.9%与3.8%,P=0.003).
结论:
- 新一代设备在治疗严重的大动脉吐时表现出相当大的有效性和安全性.
- 与"非标签"使用相比,在AR的TAVR中使用"标签上"的设备与明显更好的安全性和有效性结果有关.
- 这些发现支持优先使用"标签上的"NGD来优化严重AR患者的结果.
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