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在使用左心室辅助装置的患者中,对过导管大动脉置换与手术大动脉置换的综合比较分析

Dimitrios E Magouliotis^1,2, Grigorios Giamouzis³, Thanos Athanasiou⁴

¹Department of Cardiac Surgery Research, Lankenau Institute for Medical Research, Main Line Health, Wynnewood, PA, 19096, USA. dimitrios.magouliotis.18@alumni.ucl.ac.uk.

General thoracic and cardiovascular surgery

|October 26, 2024

概括

过导管大动脉置换 (TAVR) 对患有左心室辅助装置 (LVAD) 和大动脉衰竭的患者显示出比手术大动脉置换 (SAVR) 更好的结果. 在没有影响整体存活率的情况下,TAVR减少了并发症和成本.

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:

患有左心室辅助装置 (LVAD) 的患者的大动脉衰竭存在独特的管理挑战.
超导管大动脉置换 (TAVR) 和外科大动脉置换 (SAVR) 是治疗选择,但在这个特定人群中,对比结果尚未确定.

研究的目的:

为了比较TAVR与SAVR在LVAD和大动脉缺陷患者的长期临床和经济结果.
评估TAVR的安全性和有效性,作为这种高风险患者群体中SAVR的替代品.

主要方法:

一项全面的文献搜索确定了14项涉及358名患者的研究 (242 TAVR,116 SAVR),这些研究在1990年至2023年之间发表.
主要终点:综合住院死亡率,中风,心脏病发作,心脏起器植入,血管并发症和吸管.
二级终点:整体存活率,急性损伤,出血,重新干预和成本.

主要成果:

与SAVR组相比,TAVR组的复合结局,急性损伤,需要输血的出血和成本明显较低.
在TAVR和SAVR之间没有观察到平均整体存活时间的显著差异.
在TAVR组中,平均整体存活时间为18个月,心力衰竭进展和肺炎是最常见的死亡原因.

结论:

通过导管的大动脉置换 (TAVR) 与手术大动脉置换 (SAVR) 相比,与左心室辅助装置 (LVAD) 和大动脉功能不全患者的改善结果和降低成本有关.
需要进一步进行更大的样本大小的强有力的研究来证实这些发现并指导临床实践.

关键词:

左心室辅助装置的使用死亡率死亡率死亡率结果的结果.一次性中风,中风.通过导管更换大动脉门.

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