心脏吸管复杂化过导管大动脉置换:来自单一中心注册表的见解
Ibrahim Naoum1, Amnon Eitan1, Hussein Sliman1
1Department of Cardiology, Lady Davis Carmel Medical Centre, and the Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
CJC open
|March 10, 2025
概括
跨导管大动脉置换 (TAVR) 期间的心脏吸管可能源于各种损伤. 谨慎使用导线可以减少左心室穿孔,这是这种严重并发症的常见原因.
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:
- 心脏吸管是通过导管的大动脉置换术 (TAVR) 的严重并发症.
- 它通常由心脏起器电极对右心室 (RV) 的损伤,导导线/导管对左心室 (LV) 的损伤,或在门植入过程中发生大动脉环断裂引起.
研究的目的:
- 为了研究心脏栓塞并发症TAVR的机制.
- 确定导致这种并发症的因素,并告知预防策略.
主要方法:
- 一个TAVR机构数据库的回顾性分析.
- 审查了2010年至2024年期间进行的1247个TAVR程序.
- 吸血管的原因和患者的结果的分类.
主要成果:
- 在1.7%的TAVR手术中发生了心脏吸管 (21/1247).
- 左心室 (LV) 穿孔 (48%) 是最常见的原因,其次是VR穿孔 (38%) 和环状破裂 (14%).
- 精细的导线协议减少了 LV 穿孔事件; 43% 的患者在指数住院期间死亡.
结论:
- 在TAVR过程中心脏吸管是由于各种机制造成的,包括LV和RV穿孔和环状破裂.
- 实施谨慎的导线操纵协议可能会降低LV穿孔的发生率.
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