在经导管边缘到边缘修复后重复中枢干预:COAPT试验
Bahira Shahim1, David J Cohen2, Federico M Asch3
1Clinical Trials Center, Cardiovascular Research Foundation, New York, New York; Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Cardiology Unit, Karolinska University Hospital, Stockholm Sweden.
The American journal of cardiology
|May 24, 2024
概括
经过过导管端到端修复 (TEER) 后3.9%的患者需要重复 mitra 门干预 (RMVI). 虽然成功,但RMVI与更多的心力衰竭住院病例有关,尽管这些在手术后减少了.
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
- 心脏衰竭管理的管理
背景情况:
- 过导管边缘到边缘修复 (TEER) 用于二次 mitrale 吐 (MR).
- 在TEER之后,对重复的 mitra 干预 (RMVI) 的需要和结果尚未得到充分证实.
- COAPT试验为心力衰竭患者提供了TEER的数据,患者有功能性MR.
研究的目的:
- 为了确定在COAPT试验中TEER后RMVI的频率和结果.
- 分析与RMVI相关的患者特征.
- 评估RMVI对心力衰竭住院和死亡率的影响.
主要方法:
- 从COAPT试验中对接受TEER的患者进行分析.
- 评估累积发病率,成功率和RMVI的原因.
- 在患有和没有RMVI的患者之间比较结果 (心力衰竭住院,死亡率).
主要成果:
- 3.9%的患者在TEER后4年内需要RMVI.
- 在80%的病例中,RMVI成功.
- 接受RMVI治疗的患者患心力衰竭住院的比例较高,在重复干预后降低.
结论:
- 对于二次MR的TEER后的RMVI是罕见的,但与心力衰竭住院增加有关.
- 重复干预可以减少心力衰竭和术后住院.
- 使用MitraClip的TEER表明对后续干预的需求很低.
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