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超腔透管大动脉置换的结果和安全性:系统性审查和元分析

Adil Salihu¹, Clémence Ferlay², Matthias Kirsch³

¹Division of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.

The Canadian journal of cardiology

|May 26, 2024

概括

通过导管的大动脉置换 (TAVR) 的跨腔 (TCv) 方法对于无法接受输血性TAVR的患者是有效和安全的. 结果显示,死亡率和并发症率与其他TAVR接入路线相比相当.

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
手术创新在外科创新.

背景情况:

穿腔 (TCv) 血管方法是跨导管大动脉置换 (TAVR) 的新兴替代方案.
对于那些不适合使用标准输血道治疗的患者来说,这尤其重要.
评估TCv-TAVR的疗效和安全性对于扩大治疗选择至关重要.

研究的目的:

系统地审查和元分析TCv-TAVR的疗效,安全性和临床结果.
将TCv-TAVR结果与现有的TAVR接入路线进行比较.

主要方法:

系统审查和对2023年12月之前发表的研究进行元分析.
在PubMed/Medline,Embase和Cochrane图书馆进行了搜索.
评估了30天/1年全因死亡率,再住院和术前/术后并发症.

主要成果:

包括8项研究,467名患者;TCv-TAVR成功率为98.5%.
30天全因死亡率为6.1%,一年死亡率为14.9%.
术后并发症包括中风 (3.3%),血管 (8.7%) 和出血 (7.5%);观察到血管并发症的下降趋势.

结论:

TCv-TAVR显示了有利的安全性和有效性概况.
死亡率和并发症率与其他TAVR接入路线相比较.
技术和技术的改进正在减少血管并发症,支持TCv作为可行的替代通道.

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