伴心管过导管边缘到边缘修复二次伴心管反与保存左心室功能
Chetan P Huded1, Adnan K Chhatriwalla1, Miloni A Shah2
1Saint Luke's Mid America Heart Institute, Kansas City, Missouri, USA; University of Missouri-Kansas City, Kansas City, Missouri, USA.
JACC. Cardiovascular interventions
|November 13, 2024
概括
交叉导管边缘到边缘修复 (MTEER) 显示出很高的成功率,并改善了二次交叉导管吐 (sMR) 患者的健康状况. 结果与减少喷射分数的结果相似,心力衰竭住院率较低.
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
- 心脏门疾病 心脏门疾病
背景情况:
- 在患有二次伴膜反 (sMR) 和保存左心室喷射分数 (LVEF) 的患者中,伴膜跨导管端到端修复 (MTEER) 的结果仍然不确定.
- 了解MTEER在这个特定的患者群体中的疗效对于治疗指南至关重要.
研究的目的:
- 描述在LVEF保存 (> 50%) 的患者中对sMR的MTEER的结果.
- 为了将这些结果与为sMR接受MTEER的患者进行比较,LVEF降低 (20-50%).
主要方法:
- 分析了STS/ACC TVT注册表数据,其中包括为sMR进行MTEER的12,083名患者.
- 根据LVEF类别 (>50% vs. 20-50%) 和残留额外外 (MR) 严重程度进行了风险调整后的结果比较.
- 评估技术成功,并发症,1年死亡率,心力衰竭住院和KCCQ分数.
主要成果:
- 在LVEF组之间,技术成功,住院并发症和1年死亡率在LVEF组之间相似 (>50%对20-50%).
- 保存LVEF的患者经历了较低的一年心力衰竭住院率 (调整HR:0.81).
- 在保存LVEF的患者中,中度残留MR与1年死亡和心力衰竭住院的风险增加有关.
- 在1年后,在保存的LVEF组中,在残留MR严重程度上观察到KCCQ得分的显著改善.
结论:
- 在具有保存LVEF的sMR患者中,MTEER与高技术成功率和低并发症率有关.
- MTEER导致该人口的健康状况大幅改善.
- 剩余MR的严重程度会影响结果,强调在MTEER后实现最佳结果的重要性.
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