在跨导管大动脉植入后,在第二天出院后重新接收
Rodrigo Bagur1, Michael W A Chu1, Conrad Kabali2
1Heart Team, London Health Sciences Centre, Western University, London, ON, Canada.
概括
在使用新型的横管大动脉 (THVs) 植入过导管大动脉 (TAVI) 后,第二天的排出是安全的. 这种方法没有增加30天的再入院因任何原因,包括心力衰竭或心脏起器植入.
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:
- 对于较新的透气管心脏 (THVs) 存在有限的比较数据,这些数据涉及在输血 (TF) 透气管大动脉植入 (TAVI) 后的第二天排出 (NDD).
- 在不同THV世代中评估NDD的安全性对于优化患者护理途径至关重要.
研究的目的:
- 为了评估NDD的安全性,未经选择的患者接受TF-TAVI与ACURATE,Evolut和SAPIENTHVs.
- 为了在TAVI后一天出院的患者中比较不同THV类型的30天无计划再入院率.
主要方法:
- 一个多中心注册963名患者接受TF-TAVI,没有手术前心脏起器植入,第二天没有新心脏起器就出院.
- 利用治疗加权 (IPTW) 倾向性得分的逆概率和修改的波松回归来比较30天再入院率.
- 主要终点是30天无计划的再入院,并对心脏,非心脏,起器和心力衰竭相关的再入院进行了二次分析.
主要成果:
- 在ACURATE,Evolut和SAPIEN THV之间没有观察到30天再接收率的显著差异 (总体再接收率为8%).
- 具体的再入院原因,包括心脏事件,非心脏事件,新的永久性起器植入物和心力衰竭,在THV组中没有显著变化.
- 患者人口结构有所不同,ACURATE患者年龄较大,女性更多,而Evolut患者的STS得分更高,但这些都没有影响结果.
结论:
- 使用新一代THV的TF-TAVI后的第二天出院是之前没有心脏起器的患者的安全策略.
- 无论使用何种THV,NDD与30天再入院,死亡率或特定不良事件的增加无关.
- 这些发现支持了在各种当代THV平台上早期放电协议的可行性.
相关概念视频
Cardiac Catheterization IV: Nursing Management
1.2K
Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
1.2K
Aortic Regurgitation II: Clinical Features and Diagnostic Tests
1.2K
Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
1.2K
Aortic Regurgitation III: Medical Management
599
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...
599
Endocarditis III: Medical Management
390
Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
390
Aneurysm III: Interprofessional Care
479
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
479
Aneurysm IV: Nursing Management
627
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
627


