在接受过导管端到端修复的患者中,非工作时间设置的含义,以治疗 mitrale regurgitation
Alon Shechter1, Aakriti Gupta2, Danon Kaewkes3
1Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA; Department of Cardiology, Rabin Medical Center, Petach, Tikva, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
American heart journal
|January 4, 2025
概括
在高风险患者中,为 mitrale regurgitation (MR) 进行非工作时间的跨导管端到端修复 (TEER) 是常见的. 尽管如此,经验丰富的团队确保TEER是安全的,可行的,有效的,无论时间如何.
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:
- 通过导管的边缘到边缘修复 (TEER) 对于 mitrale 吐 (MR) 是一个关键的干预.
- 关于在标准工作时间 (工作时间以外) 进行的TEER的安全性和有效性的数据有限.
研究的目的:
- 为了调查非工作时间的部TEER的患病率,患者特征和结果.
- 为了比较非工作时间的TEER与正常时间进行的手术.
主要方法:
- 一个单一中心注册1177个孤立的,首次进行的部TEER手术的回顾性分析.
- 倾向性得分匹配被用来创建一个可比的队列进行分析.
- 评估的结果包括死亡率,心力衰竭住院和MR持续性.
主要成果:
- 9.9%的TEER手术是在工作时间之外进行的,通常是在紧急情况下与血液动力学受损的患者进行的.
- 办公时间以外的手术与更高的并发病率,晚期心力衰竭和更高的干预风险有关.
- 尽管风险较高,但技术成功率 (>97%) 和MR严重程度的改善在不同组之间是相似的. 然而,在工作时间之外的组中,早期死亡率和HF住院率较高,尽管与匹配后的时间无独立关联.
结论:
- 办公时间以外的米特拉TEER是一种非罕见的手术,经常在高风险患者中进行.
- 当由经验丰富的干预医生进行时,非工作时间的米特拉TEER是安全的,可行的和有效的.
- 倾向性得分匹配没有显示出任何显著的结果差异,这表明时间本身不是经验丰富的手中的负面预测指标.
相关概念视频
Mitral Regurgitation I: Introduction
Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
Mitral Regurgitation II: Clinical Features and Diagnostic Tests
Mitral regurgitation (MR) is a valvular heart disorder in which the mitral valve fails to close tightly, allowing blood to leak backward into the heart. Understanding the clinical manifestations, assessment, diagnostic findings, and medical management of MR is crucial to effectively managing affected patients.Clinical Manifestations of Mitral RegurgitationMitral regurgitation can be acute or chronic, each presenting differently and requiring different approaches:1. Acute Mitral...
Mitral Regurgitation III: Medical Management
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...
Mitral Regurgitation IV: Nursing Management
Mitral regurgitation (MR) is a condition where the mitral valve does not close properly, leading to the backward flow of blood from the left ventricle into the left atrium during systole. This condition can arise from various causes, including rheumatic fever, infective endocarditis, or degenerative valve disease. Effective nursing management is crucial to optimizing patient outcomes and involves comprehensive assessment and targeted interventions.Comprehensive Patient AssessmentA detailed...
Mitral Stenosis III: Medical Management
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...
Mitral Stenosis IV: Nursing Management
A comprehensive nursing assessment is essential for patients with valvular heart disease, which involves any dysfunction of the heart valves that could impact blood flow and overall heart function.Subjective Data Collection:Chief Complaint and Present Illness: Start with the patient's primary concerns, focusing on the onset, duration, and progression of cardiac symptoms such as dyspnea, fatigue, chest pain, and palpitations.Past Medical History: Collect detailed information on any previous...


