创新型的利索特里普西辅助跨导管大动脉置换可能降低大动脉根断裂的风险
Puvi Seshiah1,2, Joseph Choo1,2, Santiago Garcia1,2
1The Christ Hospital Heart and Vascular Institute, Cincinnati, Ohio.
概括
在过导管大动脉置换 (TAVR) 之前的血管内透症 (IVL) 可能会改善严重形大动脉狭窄症患者的结果. 这种方法可能会降低与TAVR相关的风险,例如大动脉环状破裂和围泄漏.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 医疗器械 医疗器械
背景情况:
- 严重的状大动脉狭窄症 (AS) 可用跨导管大动脉置换术 (TAVR) 治疗.
- 门叶片,环和左心室外流通道的严重化为TAVR带来了挑战.
- 这些挑战包括增加大动脉根/状裂纹和围泄漏 (PVL) 的风险.
研究的目的:
- 评估在TAVR之前在严重化大动脉门的患者中使用静脉内石 (IVL) 的安全性和有效性.
- 评估IVL是否可以减轻TAVR期间严重化的风险.
主要方法:
- 三名患有症状严重的AS和严重化的门的患者用气球可扩展 (BEV) 进行TAVR.
- 第一个患者在没有IVL的情况下接受了TAVR,并经历了需要手术救援的环状破裂.
- 接下来的两名患者在BEV植入之前接受了本源的IVL.
主要成果:
- 在TAVR之前接受IVL治疗的两名患者没有复杂的手术.
- 在这些情况下,观察到非常好的门框架膨胀.
- 在IVL治疗的患者中,在TAVR后没有发现显著的残留梯度或PVL.
结论:
- 严重化的大动脉膜增加了TAVR期间环状破裂和PVL的风险.
- 在TAVR前的IVL可能会提高传单和环形合规性.
- 在复杂的性AS病例中,IVL有可能提高TAVR的安全性和有效性.
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