在外科手术或通过导管更换双主动脉之后,上升性大动脉直径的进展
Giovanni Alfonso Chiariello1,2, Michele Di Mauro3, Annalisa Pasquini1,2
1Department of Cardiovascular Sciences, Agostino Gemelli Foundation Polyclinic IRCCS, Rome, Italy.
概括
在双主动脉 (AV) 患者的外科动脉置换 (SAVR) 显示,上升性大动脉 (AA) 扩张的进展比过导管动脉植入 (TAVI) 减少. 这一发现凸显了SAVR作为在这个患者群体中管理AA扩张的潜在优越选择.
科学领域:
- 心脏病学 心脏病学
- 血管外科 血管外科
- 生物医学工程 生物医学工程
背景情况:
- 双主动脉 (AV) 与上升主动脉 (AA) 扩张有关,受遗传和血液动力学因素的影响.
- 了解不同门置换策略对AA扩张的长期影响对于患者管理至关重要.
研究的目的:
- 为了比较上升大动脉 (AA) 扩张的晚期进展,在接受大动脉置换手术 (SAVR) 的双大动脉 (AV) 患者中,与跨导管大动脉植入 (TAVI) 相比.
主要方法:
- 预期数据收集189名患有严重双 AV狭窄症的患者进行了门置换.
- 在SAVR和TAVI组之间的AA直径进展的比较,使用跨胸腔回声心脏图.
- 对手术前和长期随访AA直径差异的分析.
主要成果:
- 在平均4.6年的随访期内,TAVI患者的存活率和无事件存活率与SAVR患者相比显著降低.
- 与TAVI组 (1.65毫米) 相比,SAVR组 (0.95毫米) 的上升性大动脉 (AA) 直径进展明显较低.
- 索引AA直径进展 (按身体表面积和身高) 在SAVR组也显着较低,多变量分析确定了TAVI,基线大动脉直径和准膜泄漏作为扩张增加的预测因素.
结论:
- 外科动脉置换 (SAVR) 与双动脉 (AV) 患者的横管动脉植入 (TAVI) 相比,与长期上升动脉 (AA) 直径进展显著较少相关.
- 这些发现表明,SAVR可能在这个特定的患者群体中更好地控制大动脉扩张.
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