组合治疗的可行性:通过皮肤进行左心房尾关闭和通过导管边缘到边缘修复
Nobuyuki Fukuda1, Teruhiko Imamura2, Shuhei Tanaka1
1The Second Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan.
Cardiovascular intervention and therapeutics
|November 28, 2024
概括
结合左心房尾关闭 (LAAC) 与跨导管边缘到边缘修复 (TEER) 是心房患者的安全有效的策略. 这种综合方法显示了与单独使用LAAC相似的结果,降低了中风和出血的风险.
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:
- 心房动 (AF) 患者经常同时出现显著的额头肌吐 (MR).
- 左心房尾关闭 (LAAC) 防止了AF中的血栓栓塞,而跨导管边缘到边缘修复 (TEER) 解决了显著的MR.
- LAAC + TEER的联合疗效和可行性尚未得到充分证实.
研究的目的:
- 评估联合LAAC+TEER与单独LAAC在AF和MR患者中的可行性和对比结果.
- 为了评估程序的成功,设备相关的并发症和临床事件在1年的随访.
主要方法:
- 连续接受LAAC.患者的回顾性分析.
- 在接受LAAC + TEER组合 (n=11) 和单独接受LAAC (n=181) 的队列之间的结果比较.
- 评估手术成功,设备泄漏,与设备相关的血栓,血栓栓塞事件和出血事件.
主要成果:
- 两个组的程序成功率都很高 (100%的组合相对于99%的LAAC单独).
- 在1年内,显著的设备泄漏 (0% vs. 1.1%) 或与设备相关的血栓 (0% vs. 6.7%) 没有显著差异.
- 在两组之间,血栓栓塞 (p=0.57) 和出血事件 (p=0.42) 的可比累积发病率.
结论:
- 联合LAAC+TEER是一种可行且有效的策略,适用于精心挑选的AF和显著MR患者.
- 这种综合方法的安全性和有效性与单独使用LAAC相美.
- 推使用大量经验丰富的中心进行 LAAC + TEER 联合手术.
相关概念视频
Mitral Regurgitation III: Medical Management
686
Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
686
Mitral Stenosis III: Medical Management
535
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
535
Aortic Regurgitation III: Medical Management
598
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
598
Pericarditis III: Medical Management
586
The primary objectives of managing pericarditis are to determine the underlying cause, provide effective therapy for treatment and symptom relief, and promptly detect signs and symptoms of cardiac tamponade. The following outlines the essential aspects of medical management for pericarditis:ObjectivesDetermine the Cause: Identifying the underlying cause of pericarditis is crucial for targeted treatment. Causes include viral infections, autoimmune diseases, post-cardiac injury syndrome, and...
586
Cardiomyopathy II: Dilated Cardiomyopathy
790
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
790
Cardiomyopathy V: Interprofessional Care
753
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
753


