植入后的跨导管大动脉假体变形:三管与双管的对比
Marco Moscarelli1,2, Aniket Venkatesh3, Katelynne Berland3
1Department of Cardiovascular Surgery, Maria Eleonora Hospital, GVM Care&Research, Palermo, Italy.
概括
在患有双主动脉的患者中,透气管大动脉置换显示出假体变形和血栓的增加,与三主动脉相比,导致不良事件的风险更高.
科学领域:
- 心脏病学 心脏病学
- 放射学 放射学是一门学科.
- 生物医学工程 生物医学工程
背景情况:
- 双主动脉对跨导管主动脉置换 (TAVR) 提出了独特的解剖学挑战.
- 了解植入后假肢特征对于优化TAVR结果至关重要.
研究的目的:
- 为了比较多探测器计算机断层扫描 (MDCT) 跨导管大动脉假肢的特征,在患有原生三和双大动脉狭窄症的患者之间进行.
- 评估这些特征对门性能和TAVR后的临床结果的影响.
主要方法:
- 对100个植入后MDCT扫描进行分析,以评估六个层次的假肢扩张.
- 在6个月的随访期评估膜和周膜血栓.
- 对心声回应假肢性能和临床结果的评估.
主要成果:
- 双骨组的平均偏心率 (假肢变形) 显著更高 (0.43对0.37,P=0.005).
- 在双骨组中增加了膜和周膜血栓的发生率 (81%对36.9%,P=0.031).
- 两组之间的假肢梯度或指数有效孔面积 (EOAi) 没有显著差异,但双门的不良事件风险更高 (HR:3.72,P=0.027).
结论:
- 双动脉与更高的假体异常度有关,这表明TAVR后的变形.
- 这种变形可能会导致血栓形成的增加和更糟糕的临床结果,尽管保持了心声表现.
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