跨导管大动脉置换后的神经并发症:一篇综述
Adam S Mangold1, Stefano Benincasa1, Benjamin M Sanders1
1From the Cooper Medical School of Rowan University, Camden, New Jersey.
Anesthesia and analgesia
|August 13, 2024
概括
过导管大动脉置换 (TAVR) 是大动脉置换的主要手术. 在TAVR之后,神经系统并发症如中风和认知衰退正在减少,但需要标准化的评估方法.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 干预心脏病学 干预心脏病学
背景情况:
- 过导管大动脉置换 (TAVR) 是美国大动脉置换的主要方法.
- 神经系统并发症,包括中风,妄和认知衰退,是TAVR后的重大问题.
- 这些并发症的报告发病率已经演变,受诊断标准和方法的影响.
研究的目的:
- 审查目前关于中风,妄和TAVR后认知衰退的发生率的数据.
- 探索沉默大脑缺血病变 (SCILs) 在术后神经认知状态中的作用.
- 确定需要对TAVR相关神经复杂症进行未来研究的领域.
主要方法:
- 关于TAVR和神经结果的现有文献的叙事综述.
- 关于中风发生率的研究分析,将TAVR与外科主动脉置换 (SAVR) 进行比较.
- 讨论诊断挑战和神经认知测试方法.
主要成果:
- 随着时间的推移,TAVR后中风的发生率有所下降,大多数中风是栓塞性.
- 由于不同的诊断标准,TAVR和SAVR之间存在冲突的中风率.
- 非大腿部通道与 Delirium 和认知衰退的风险增加有关.
结论:
- 标准化成像和验证的方法对于评估TAVR后的认知变化至关重要.
- 需要进一步的研究,以了解和减轻与TAVR相关的神经风险.
- 沉默性脑缺血性病变 (SCILs) 与术后神经认知功能较差有关.
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