终身管理考虑优化跨导管大动脉植入:一个实用指南
Karan Rao1,2, Alexandra Baer3, Vinayak N Bapat4
1Royal North Shore Hospital, Sydney, Australia.
概括
通过导管的大动脉植入 (TAVI) 的计划至关重要,因为患者可能比他们的第一个门更长寿. 术前成像有助于优化初始程序,并计划未来的TAVI-in-TAVI干预,确保长期的患者护理.
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:
- 过导管大动脉植入 (TAVI) 是对大动脉狭窄的标准治疗方法.
- 扩展的指示导致更多的患者可能超过他们的初始透气管心脏 (THV).
- 对THV管理的终身规划变得越来越重要.
研究的目的:
- 审查TAVI患者的终身规划考虑因素.
- 突出程序前计算机断层扫描 (CT) 在未来防范THV程序中的作用.
- 讨论优化索引TAVI和潜在重复TAVI程序的策略.
主要方法:
- 对TAVI的当前文献和临床考虑的审查.
- 专注于手术前的CT成像实用程序.
- 对初始和重复的TAVI程序的主要优先事项的分析.
主要成果:
- 优化TAVI指数包括最大限度地提高有效孔径面积,最大限度地减少起器植入,减少准膜反,并防止冠状动脉阻塞/环膜破裂.
- 改造TAVI (TAVI-in-TAVI) 需要注意患者与假肢不匹配,导电异常,冠状动脉可回收性以及预防冠状动脉阻塞/鼻封存.
- 程序前规划可以预测重复TAVI的可行性和结果.
结论:
- 仔细的终身规划,利用手术前CT成像,对于TAVI患者至关重要.
- 优化最初的TAVI程序为更好的长期结果奠定了基础.
- 需要个性化护理策略来管理可能需要在一生中重复TAVI手术的患者.
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