在患有冠状动脉阻塞高风险的患者中进行过导管大动脉置换
Yousif Ahmad1, Luke Oakley2, Sunghan Yoon2
1Yale School of Medicine, Yale University, New Haven, Connecticut.
概括
对于在跨导管大动脉置换 (TAVR) 期间冠状动脉阻塞的高风险患者,与气球可扩展 (BE) 相比,自我扩展 (SE) 与冠状动脉阻塞和心脏死亡率更高有关.
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
- 医疗器械 医疗器械
背景情况:
- 冠状动脉阻塞是跨导管大动脉置换 (TAVR) 后的一个关键并发症.
- 高风险人群中TAVR的患者选择和门选择仍然是研究领域.
- 了解影响冠状动脉阻塞风险的因素对于改善TAVR结果至关重要.
研究的目的:
- 描述与高风险TAVR患者冠状动脉阻塞相关的解剖学和临床因素.
- 在这个高风险组中,比较气球可扩展 (BE) 和自扩展 (SE) 门平台之间的结果.
- 研究门选择对冠状动脉阻塞和死亡率的影响.
主要方法:
- 冠状动脉阻塞的高风险TAVR患者的多中心国际注册.
- 包括接受预防性冠状动脉保护策略的患者.
- 基于门类型的患者特征和结果的比较 (BE vs. SE). 在SE).
主要成果:
- 自扩展式 (SE) 门在门内手术中以及在患有较小Valsalva鼻腔和到冠状动脉距离的患者中更频繁地使用.
- 接受SE门治疗的患者出现了更高的确定的或可能的冠状动脉封闭率 (12.1%对2.1%).
- 与SE门相比,SE门的三年心脏病死亡率明显高 (21.6%),而BE门则高 (3.7%).
结论:
- 在这个高风险队列中,用SE门治疗的患者表现出导致冠状动脉阻塞的解剖学和临床特征.
- 观察到SE门的较高死亡率可能归因于患者固有的高风险表型,而不是门类型本身.
- 仔细的患者选择和考虑门平台在TAVR中至关重要,以减轻冠状动脉阻塞的风险.
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