耳前功能性 mitra 反子类型 经历过导管边缘到边缘修复:在耳前功能性腿筋中低于最佳的结果
Philipp von Stein1, Jennifer von Stein1, Christopher Hohmann1
1University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinic III for Internal Medicine, Cologne, Germany.
JACC. Cardiovascular imaging
|August 29, 2024
概括
耳前功能性额头回 (AFMR) 亚型在经过横导管边缘到边缘修复后具有不同的结果. 限制后部叶片运动的AFMR (AFMR-AH) 的结果比带有环状扩张的AFMR (AFMR-IAD) 的结果更差.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心脏外科手术 心脏外科手术
背景情况:
- 耳前功能性 mitrale 反 (AFMR) 有两种亚型:卡蒂尔类型I (隔离的 mitrale annulus扩张,AFMR-IAD) 和卡蒂尔类型IIIb (限制后部 mitrale 叶片运动,AFMR-AH).
- 了解这些AFMR亚型的独特特征和程序结果对于有效的治疗策略至关重要.
研究的目的:
- 分析AFMR-IAD和AFMR-AH患者的心声学特征和临床结果,这些患者正在接受中枢透管边缘到边缘修复 (M-TEER).
- 为了比较两种M-TEER后的AFMR亚型之间的手术成功,并发症和长期存活率.
主要方法:
- 对接受M-TEER的1,047名患者的回顾性分析确定了128名患有孤立AFMR的患者.
- 根据卡蒂尔分类,患者被分为AFMR-IAD (n=75) 和AFMR-AH (n=53) 的类别.
- 分析了心声学数据和手术后一年的结果.
主要成果:
- 与AFMR-IAD相比,AFMR-AH患者表现出较大的左心房/心室体积,较大的 mitra annulus 尺寸和更严重的 mitra regurgitation.
- 在AFMR-IAD (98.7%) 和AFMR-AH (86.8%) 中,技术成功率更高.
- 设备脱离仅发生在AFMR-AH (10.0%),与AFMR-IAD相比,AFMR-AH的MR ≤II在30天和1年后的比例明显较低. AFMR-AH与更高的程序失败和1年全因死亡率有关.
结论:
- 与隔离环状扩张 (AFMR-IAD) 的AFMR相比,在M-TEER之后,心房功能性 mitra反与限制后侧叶片运动 (AFMR-AH) 与较差的程序和临床结果有关.
- 对AFMR-AH的提高警是有必要的,对于这些患者,可能需要考虑替代性米特拉治疗.
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