操作员经验对左心室尾闭塞结果的影响
Tingting Zhang1, Chao Gao1, Jianzheng Liu1
1Department of Cardiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China.
JACC. Clinical electrophysiology
|September 13, 2024
概括
对于经验丰富的操作人员来说,每年至少进行32次左心房尾闭塞 (LAAO) 程序是关键. 每年病例数量较少会增加风险,但每增加5项手术会使不良事件减少12%.
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:
- 与左心房尾闭塞 (LAAO) 的操作员经验相关的长期结果在很大程度上仍未被描述.
- 了解这种关系对于优化患者安全和程序成功至关重要.
研究的目的:
- 调查经营者的经验水平与LAAO程序后的一年临床结果之间的关联.
- 根据程序量,确定LAAO运营商经验的潜在门.
主要方法:
- 来自前性多中心RECORD研究 (NCT03917563) 的数据分析,该研究涉及在中国使用WATCHMAN设备进行LAAO的患者.
- 纳入标准侧重于仅患有LAAO的患者,不包括那些同时接受手术的患者.
- 主要结局是所有原因的死亡,中风,全身栓塞和学术研究联盟 (BARC) 定义的1年3或5型出血.
主要成果:
- 分析了1547名患者和111名操作人员. 最佳的年度操作员经验值被确定为≥32个LAAO程序.
- 与每年执行≥32个LAAO的运营商相比,每年执行<32个LAAO的运营商的初级复合终点风险增加了1.79倍.
- 对于低于值的运营商来说,每年执行的每5个LAAO病例都与初级终点风险降低约12%有关.
结论:
- 每年进行≥32次左心房尾闭塞手术是操作员经验的重要门.
- 达到这种年度程序量与一年内改善的临床结果有关.
- 程序量是一个可修改的因素;经验的增加明显降低了LAAO的不良事件率.
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