与其他门疾病相关的严重大动脉狭窄症:开放式手术还是皮肤内治疗?
Sergio Moral1,2,3, Marc Abulí1, Esther Ballesteros4
1Cardiology Department, Hospital Universitari Doctor Josep Trueta, 17007 Girona, Spain.
Reviews in cardiovascular medicine
|July 30, 2024
概括
通过导管的大动脉置换 (TAVR) 治疗严重的大动脉狭窄症 (AS) 在年轻患者中越来越多地使用,当其他膜心脏疾病 (VHD) 存在时,就会使治疗复杂化.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 膜心脏疾病 膜心脏疾病
背景情况:
- 严重的大动脉狭窄 (AS) 与同时存在的膜心脏病 (VHD) 的治疗决策是一个日益增长的临床挑战.
- 对AS的透管大动脉置换 (TAVR) 正在扩大到年轻,风险较低的人群中,加剧了对相关VHD的最佳管理策略的需求.
研究的目的:
- 审查有关严重AS与显著VHDs相关的病理生理学和预后的当前文献.
- 为了评估AS患者的最佳侵入性治疗方法,同时存在着额头骨反,额头骨狭窄或三骨反.
主要方法:
- 对近期出版物的系统审查.
- 对AS和VHD结合的病理生理学,预后和治疗选择的分析.
- 通过皮肤和手术治疗策略的评估.
主要成果:
- 关联的额头吐 (MR),额头狭窄和三角吐 (TR) 在接受TAVR的AS患者中很常见.
- 许多显著的MR或TR病例可能在没有特殊干预的情况下改善TAVR后.
- 未经治疗的相关VHDs的侵略性进展的预测因素仍然不确定.
结论:
- 严重的AS与相关的VHD的管理需要仔细考虑个体患者的因素和不断发展的皮肤技术.
- 需要进一步的研究来澄清这些复杂的膜心脏病的自然史和最佳治疗顺序.
更多相关视频
相关概念视频
Mitral Regurgitation III: Medical Management
Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
Mitral Stenosis I: Introduction
Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
Mitral Stenosis III: Medical Management
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
Mitral Stenosis IV: Nursing Management
A comprehensive nursing assessment is essential for patients with valvular heart disease, which involves any dysfunction of the heart valves that could impact blood flow and overall heart function.Subjective Data Collection:Chief Complaint and Present Illness: Start with the patient's primary concerns, focusing on the onset, duration, and progression of cardiac symptoms such as dyspnea, fatigue, chest pain, and palpitations.Past Medical History: Collect detailed information on any previous...
Aortic Regurgitation III: Medical Management
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
Aneurysm III: Interprofessional Care
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...


