塔维超时表现的演变:系统审查的概述
Carmen Angioletti1, Giaele Moretti2, Stefania Manetti3
1Management and Healthcare Laboratory, Institute of Management, Sant'Anna School of Advanced Studies, Pisa, Italy.
BMC cardiovascular disorders
|June 21, 2024
概括
通过导管的大动脉植入 (TAVI) 是有效的严重的大动脉狭窄跨风险群体. 这一系统性审查的概述显示,与手术可比的死亡率,但TAVI的出血和损伤率较低.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 通过导管的大动脉植入 (TAVI) 是建立的高/中等风险严重的大动脉狭窄 (AS).
- 最近的证据表明,TAVI在低风险患者中不低于外科上门置换 (SAVR) 的劣势.
- 许多系统文献评论 (SLRs) 存在,但这是对TAVI临床结果的SLRs (OoSRs) 的第一个概述.
研究的目的:
- 提供关于TAVI系统性审查 (OoSRs) 的概述.
- 总结TAVI临床结果和过程指标的发现.
- 分析TAVI表现的演变和患者风险分层.
主要方法:
- 在MEDLINE和Cochrane图书馆对SLR进行全面的文献搜索,截至2024年4月.
- 纳入标准侧重于SLR报告TAVI的临床指标.
- 两步选 (标题/摘要,然后是全文) 和包含的评论的质量评估.
主要成果:
- 包括33个SLR,涵盖了各种患者风险概况 (STS分数).
- 在TAVI和SAVR之间,死亡率相似.
- TAVI显示较低的重大出血率,急性损伤 (AKI) 和新发动的心房动,但较高的血管并发症率,心脏起器植入和残留大动脉吐.
结论:
- 自2020年以来,TAVI的表现已经进化,并扩大了包括低风险患者的指示.
- 塔维显示出有利的结果,特别是减少出血和AKI.
- 目前正在进行的研究和开发继续完善TAVI程序并解决相关挑战.
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