透气管中枢替换使用 annular 减少通过 cinching 与 TEER 在委员会 (北极) 的切割
Gregory J Condos1, David Elison1, Logan L Vincent2
1Department of Cardiology (G.J.C., D.E., C.S., C.J.C., J.M.M.), University of Washington School of Medicine, Seattle.
Circulation. Cardiovascular interventions
|November 6, 2024
概括
这项研究提出了一种新型的混合手术,用于额头环状化,将跨导管边缘修复 (TEER) 与门更换相结合. 这种新的方法成功地治疗了不适合现有的透导管疗法的大额杆环患者.
科学领域:
- 心血管医学 心血管医学
- 干预心脏病学 干预心脏病学
- 结构性心脏病是一种心脏病.
背景情况:
- 伴有严重门功能障碍的中枢环状化 (MAC) 是一个重大的临床挑战.
- 高度的手术风险和有限的透导管选择使这些患者的管理变得复杂.
研究的目的:
- 描述一项用于治疗大 mitra annuli 的新杂交手术的初始经验.
- 评估结合辅管管道端到端修复 (TEER) 与门内MAC管道管道中门更换 (TMVR) 的可行性.
主要方法:
- 采用了一种两阶段的混合方法:使用MitraClip的委托式TEER,然后用气球可扩展的大动脉 (SAPIEN 3) 进行穿越性TMVR.
- 选择的患者有较大的额头环和足够的化,有高的栓栓塞的风险.
- 该程序旨在在更换门之前缩短门间距离.
主要成果:
- 这项研究包括13名患者,其中位数间隔距离为39.1毫米,环形面积为930毫米2.
- 在所有患者中,commissural TEER是成功的. 在13名患者中,12名患者的门植入成功.
- 在成功的植入物中,膜漏洞轻微 (≤1+),没有与TEER装置相邻的漏洞.
结论:
- 一种混合的TEER和SAPIEN门置换策略是可行的,对于患有大额头环和MAC的患者.
- 这种新的方法可以促进在具有挑战性的解剖学中通过导管进行心心膜更换.
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