边缘到边缘与手术修复的结果,在功能性额叶回和左心室功能减少的患者中
Daniel Silva1, Peter Wohlmuth2, Friedrich-C Rieß3
1Cardiac Surgery Department, Albertinen Heart Center, Hamburg, Germany. dmiguez77@yahoo.com.
Herz
|February 21, 2025
概括
使用MitraClip系统进行皮肤穿透边缘修复 (TEER) 和手术修复,在患有严重功能性腹和左心室功能减弱的患者中显示出类似的中期结果. 这两种方法都提供了可比的生存率,重新干预率,心力衰竭症状和改善的额头骨吐.
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:
- 严重的功能性额头吐 (fMR) 随着左心室喷射率 (LVEF) 的降低,带来了重大管理挑战.
- 通过皮肤进行边缘到边缘修复 (TEER) 与手术修复进行比较对于优化患者的治疗结果至关重要.
研究的目的:
- 为了比较使用第一代MitraClip系统的TEER的中期结果与严重fMR和LVEF≤45%的患者的手术修复.
主要方法:
- 连续接受隔离外科手术修复或植入MitraClip (2007-2015) 的患者的回顾性分析.
- 在12个月和24个月后进行临床和心声学随访.
- 倾向性得分匹配用于调整年龄,性别,EuroSCORE,LVEF和冠状动脉疾病的基线差异.
主要成果:
- 确定了167名患者;83人 (49.7%) 进行了手术修复,84人 (50.3%) 进行了MitraClip植入.
- 在倾向分数匹配 (n=74) 后,没有观察到群体之间的显著差异.
- 关键结局包括生存率,再干预率,NYHA类,额头上重度和LVEF是可比的.
结论:
- 在患有严重fMR和减少LVEF的患者中,TEER与第一代MitraClip设备的中期疗效与手术修复相似.
- 这两种方法在生存,再干预,心力衰竭症状和心声回声学参数方面都产生了可比的结果.
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