在指数程序下救助ViV-TAVI的长期结果
Isabel Horn1, Hazem Omran2, Sabine Bleiziffer3
1Klinik für Allgemeine und Interventionelle Kardiologie/Angiologie, Herz- und Diabeteszentrum NRW, Georgstr. 11, 32545, Bad Oeynhausen, Germany. ihorn@hdz-nrw.de.
概括
救助入透导管大动脉植入 (ViV-TAVI) 是失败的TAVI手术的可行选择. 然而,与成功的TAVI相比,这种方法与长期死亡率显著上升有关.
科学领域:
- 心血管医学 心血管医学
- 干预心脏病学 干预心脏病学
- 医疗器械 医疗器械
背景情况:
- 过导管大动脉植入 (TAVI) 是对大动脉狭窄的标准治疗方法.
- 在TAVI后的门故障可能需要进一步的干预.
- 救援入TAVI (bViV-TAVI) 是在同一过程中管理TAVI故障的一个选项.
研究的目的:
- 为了比较bViV-TAVI与成功的TAVI的住院和长期结果.
- 评估作为救助策略执行的第二个TAVI程序的安全性和有效性.
主要方法:
- 从2011年2月到2022年3月,对4555名TAVI患者进行了回顾性分析.
- 鉴定和匹配231名接受bViV-TAVI (n=77) 和成功接受TAVI (n=154) 的患者.
- 主要终点:长期死亡率. 二级终点:住院死亡率,中风,急性功能衰竭,心脏起器植入,干预时间.
主要成果:
- bViV-TAVI是一个罕见的事件 (1.9%),通常是由于膜栓塞/迁移 (76.7%) 或显著的准膜泄漏 (23.4%).
- bViV-TAVI手术时间较长,新的永久心脏起器植入率更高,手术后平均压力更高.
- 在平均随访时间为4.9年后,bViV-TAVI组的长期死亡率明显高于bViV-TAVI组 (54.5%对39.0%,p=0.025).
结论:
- 救助ViV-TAVI是失败的TAVI程序的可行治疗方法.
- 接受bViV-TAVI治疗的患者长期死亡率显著增加.
- 仔细选择患者和考虑长期风险对于bViV-TAVI至关重要.
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