透导管修复与二次腹吐中枢手术对比二次腹吐
Stephan Baldus1, Torsten Doenst1, Roman Pfister1
1From the Department of Internal Medicine III (S.B., R.P.), the Institute of Medical Statistics and Computational Biology (W.M., J.F., M.H.), and Cardiothoracic Surgery (T. Wahlers), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, the Department of Cardiothoracic Surgery (T.D.) and Cardiology (P.C.S.), Jena University Hospital, Friedrich-Schiller-University of Jena, Jena, Thoracic and Cardiovascular Surgery (J.G.) and General and Interventional Cardiology/Angiology (V.R.), Heart and Diabetes Center NRW, University Hospital of the Ruhr-University Bochum, Medical Faculty OWL, Bad Oeynhausen, the Department of Cardiology, Ulm University Heart Center, Ulm (M. Kessler, W.R.), the Faculty of Health, School of Medicine (P.B.), and Helios Klinikum Krefeld (A.B.), University Witten/Herdecke, Witten, Marienkrankenhaus (E.L.), the Department of Cardiology, University Hospital Eppendorf (E.L.), and the Department of Cardiothoracic Surgery, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf (H.R.), Hamburg, the Department of Internal Medicine I, University Hospital Aachen, RWTH Aachen University, Aachen (J.S.), Cardiac Surgery (T.N.), Heart Center Leipzig at Leipzig University (H.T.), and Leipzig Heart Science (H.T.), Leipzig, the Department of Cardiovascular Surgery, University Hospital Frankfurt and Goethe University Frankfurt, Frankfurt (T. Walther), University Hospital Düsseldorf and CARID (Cardiovascular Research Institute Düsseldorf), Düsseldorf (M. Kelm), Medical Clinic and Polyclinic I (J.H.) and the Department of Cardiac Surgery (C.H.), Ludwig Maximilian University Munich, Munich, Medical Clinic II, University Heart Center Lübeck, and the German Center for Cardiovascular Research (DZHK), Lübeck (I.E.), the Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim (U.F.-R.), Otto-von-Guericke-University Magdeburg, Magdeburg (A.S.), the Department of Cardiology, University Medical Center Rostock, Rostock (H.I.), the Department of Cardiology, University Medical Center Mainz (P.L., R.S.B.), and the German Center for Cardiovascular Research (DZHK) partner site Rhine Main (P.L.), Mainz, St. Franziskus Hospital, Münster (S.R.), and the Department of Cardiology, Helios Klinikum Siegburg, Siegburg (H.B.) - all in Germany.
横导管边缘到边缘的修复与心力衰竭患者的手术一样有效. 这种最少的侵入性方法在一年内显示主要不良事件的非劣势性.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心脏衰竭管理的管理
背景情况:
- 目前的指导方针建议通过导管进行边缘到边缘修复 (TEER) 或对心力衰竭进行二次 mitrale 吐的 mitrale 手术.
- 随机试验数据直接比较这些疗法在这个特定的患者群体是有限的.
研究的目的:
- 为了比较TEER的疗效和安全性与心力衰竭和二次心心回的患者的常规 mitra 门手术.
- 为了确定TEER是否在关键临床结果方面与外科手术无差.
主要方法:
- 一项非劣势性随机试验,涉及210名患者,尽管接受了医疗治疗,但患有症状性心力衰竭和二次心肌吐.
- 患者被分为1:1接受TEER或手术修复/更换米特拉.
- 主要疗效终点:死亡,心力衰竭住院,重新干预,辅助设备或一年内中风的复合.
- 主要安全终点:主要不良事件发生在30天内.
主要成果:
- 在初级疗效终点方面,TEER与手术无差 (16.7%与1年后的22.5%;P<0.001为非劣势).
- 与手术相比,TEER在30天内显著降低了主要不良事件的发生率 (14.9%与54.8%相比;P<0.001).
结论:
- 横导管边缘到边缘修复是对心脏衰竭和二次心肌吐症患者选择的 mitra 门手术的可行和安全的替代方案.
- 这些发现支持TEER作为一种非劣质的治疗选择,特别是在安全结果方面.
相关概念视频
Mitral Regurgitation I: Introduction
Mitral Regurgitation II: Clinical Features and Diagnostic Tests
Mitral Regurgitation III: Medical Management
Mitral Regurgitation IV: Nursing Management
Mitral Stenosis II: Clinical features and Diagnostic Tests
Mitral Stenosis III: Medical Management


