跨导管大动脉替换后的导电障碍:关于流行病学,预防策略和管理的最新情况
Jorge Nuche1, Kenneth A Ellenbogen2, Suneet Mittal3
1Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada; Servicio de Cardiología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria 12 de Octubre, Madrid, Spain; Consorcio de Investigación Biomédica en Red-Cardiovascular, Madrid, Spain.
JACC. Cardiovascular interventions
|November 27, 2024
概括
透气管大动脉置换 (TAVR) 后的导电障碍 (CDs) 仍然很常见,尽管有所改善. 优化植入深度等策略可能会减少CD并改善患者的治疗结果.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心脏外科手术 心脏外科手术
背景情况:
- 导电障碍 (CDs) 是通过导管的大动脉置换 (TAVR) 后的常见并发症.
- 尽管TAVR技术和技术的进步,CD的发病率仍然保持在两位数的百分比.
- 在TAVR后的CD与不良患者结果有关,因此需要预防和管理策略.
研究的目的:
- 审查目前关于TAVR.后CDS流行病学,影响和管理的证据.
- 识别风险因素,包括不可修改的 (例如,前右束分支块) 和可修改的因素 (例如,植入深度).
- 提出一个更新的,紧随TAVR的CD快速管理协议.
主要方法:
- 关于TAVR相关传导障碍的最新研究的综合文献综述.
- 对流行病学数据,临床影响和风险因素的分析.
- 评估预防策略和当前管理准则.
主要成果:
- 不能改变的因素,比如之前的右捆分支堵塞增加了心脏起器植入器的风险TAVR后.
- 可修改的因素,特别是较低的植入深度,与较高的CD率有关.
- 更高的植入深度和特定的植入策略在减少CDs方面显示出希望.
结论:
- 减少TAVR后CD的发生率对于改善患者的治疗结果至关重要.
- 优化植入深度和采用先进技术是关键的预防策略.
- 一个更新的快速管理协议可以帮助有效地处理TAVR后的CD.
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