透导管大动脉替换与核心自扩展生物假体:临床和耐用性数据高达12年
Luca Testa1, Cristina Giannini2, Giulia Costa2
1Cardiology Department, IRCCS Policlinico S. Donato, S. Donato Milanese, Italy.
概括
第一代CoreValve生物假体在12年的随访期间,在患有严重症状性大动脉狭窄症的患者中表现出令人放心的临床和血液动力学性能,支持其长期耐用性.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 生物材料科学 生物材料科学
背景情况:
- 过导管大动脉置换 (TAVR) 已经改变了大动脉狭窄的治疗方法.
- 早期TAVR生物假体的长期耐用性数据仍然有限.
- 核心自扩展生物假体是一种广泛使用的设备.
研究的目的:
- 评估第一代CoreValve生物假体的12年临床和血液动力学结果.
- 评估TAVR在严重的症状性大动脉狭窄症中的长期耐用性.
- 分析TAVR后的死亡率和结构的恶化率.
主要方法:
- 一组882名高风险患者接受了CoreValve生物假体.
- 随访时间延长至12年,使用VARC-3定义.
- 终点包括所有原因/心血管死亡率和门恶化事件 (SVD,BVD,BVF,HVD).
主要成果:
- 十二年死亡的精算风险为95.5%.
- 12年的实际风险包括心血管死亡 (23.9%),生物假体功能障碍 (7.0%),结构损坏 (3.6%),生物假体故障 (3.12%) 和严重的血液动力损坏 (1.7%).
- 术后的平均下垂梯度显著下降,并在12年后保持稳定.
结论:
- 第一代CoreValve生物假体在12年随访后表现出令人放心的临床和血液动力学性能.
- 这表明这种早期TAVR设备的可接受的长期耐用性.
- 这些发现支持对TAVR生物假体寿命的持续评估.
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