易受伤害的老年患者的左心房尾闭塞 - 在一个大型单中心注册表中的有效性和安全性
Christian Fastner1, Enise Tavas2, Svetlana Hetjens3
1Department of Cardiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, European Center for AngioScience (ECAS), and German Center for Cardiovascular Research (DZHK) Partner Site Heidelberg/Mannheim, Mannheim, Germany.
Journal of the neurological sciences
|May 10, 2025
概括
一种简化左心室尾闭塞 (LAAO) 程序在老年患者中显示出高的技术成功率和低的并发症率. 仔细选择患者至关重要,以确保LAAO的好处,特别是关于中风风险.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 老年医学 老年医学
背景情况:
- 最年长的人口需要简化医疗程序.
- 复杂的周围手术方法可能不适合老年患者.
研究的目的:
- 为了评估一个简单的,非复杂的左心房尾闭塞 (LAAO) 程序的有效性和安全性.
- 为了比较老年患者 (≥80岁) 与接受LAAO的年轻患者的结果.
主要方法:
- 自2014年以来接受LAAO的患者的回顾性评估.
- 通过预防全因死亡,中风或全身栓塞来衡量有效性.
- 通过严重出血 (≥BARC3型) 来评估安全性.
主要成果:
- 在最老的 (96.0%) 和年轻的 (98.5%) 组中,技术成功率很高.
- 最年长的患者显示过度死亡率 (22.2%对13.0%) 和更多的缺血性中风 (10.1%对3.8%) 的趋势.
- 两组之间主要并发症或主要出血没有显著差异.
结论:
- 不复杂的LAAO手术在技术上是成功的,老年患者的并发症率很低.
- 需要仔细选择患者,以确定那些有足够的预期寿命可以受益的人.
- 在老年人中增加的缺血性中风风险需要进一步调查超出LAA血栓的心血管血栓病因.
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