面对齐和ACURATE neo2跨导管大动脉:对门性能的影响
Alejandro Travieso1, Stefan Toggweiler2, Nicholas Montarello1
1The Heart Center, Rigshospitalet, Copenhagen, Denmark.
概括
在用ACURATE neo2装置替换透导管大动脉时严重的指导管错位与更差的膜血动力学和更高的大动脉吐风险有关. 正确的对齐对于最佳的TAV性能至关重要.
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
- 医疗器械技术 医疗器械技术
背景情况:
- 超导管大动脉置换 (TAVR) 越来越多地用于严重的大动脉狭窄,即使在年轻患者中.
- 有关TAVR后的长期管理,再干预和冠状动脉接入存在担忧.
研究的目的:
- 评估 commissural 对齐对ACURATE neo2 跨导管大动脉 (TAV) 的性能的影响.
主要方法:
- 在COALIGN-neo2研究中,追溯分析了接受ACURATE neo2门的TAVR患者.
- 评价了状错位 (CMA),以及跨膜梯度,有效孔径区域,患者假肢不匹配 (PPM) 和大动脉反 (AR).
主要成果:
- 严重的CMA与严重的PPM的发病率更高 (14.7%与对齐的门相比).
- 严重的CMA独立预测了严重的PPM (OR:3.12) 和≥轻度的AR (OR:2.05).
- 较高的≥轻度AR率 (51.4%) 与严重的CMA相比,与对齐的门 (34.3%) 相比,观察到较高的CMA率.
结论:
- 迄今为止,COALIGN-neo2研究是迄今为止关于 commissural alignment 和 TAV 性能的最大研究.
- 使用ACURATE neo2的严重CMA与较差的膜血液动力学和AR风险增加有关.
- 优化 commissural 对齐是 TAV 性能和减少并发症的重要.
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