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需要心脏起器植入的患者的长期结果通过导管的大动脉替换后:瑞士TAVI注册表

Patrick Badertscher¹, Stefan Stortecky², Teodor Serban¹

¹Department of Cardiology, University Hospital Basel, Basel, Switzerland; Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland.

JACC. Cardiovascular interventions

|May 14, 2025

概括

跨导管大动脉置换 (TAVR) 后的心脏起器植入与显著更高的长期死亡率有关. 需要心脏起器的患者在TAVR后面临死亡和心血管事件的风险增加,长达10年.

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
医疗器械产生的结果

背景情况:

经过过导管大动脉置换 (TAVR) 之后心脏起器 (PM) 植入的必要性和影响受到辩论,特别是在低风险人群中扩大TAVR的使用方面.
了解这些结果对于优化TAVR后患者护理至关重要.

研究的目的:

调查TAVR后30天内心脏起器植入与长期所有原因和心血管死亡率之间的关联.
为了确定与TAVR后心脏起器依赖相关的特定不良结果.

主要方法:

一个前性的,观察性的,全国性的TAVR队列研究.
包括来自19个瑞士中心的13360名患者 (2011年2月 - 2022年6月).
对2,028名患者 (15%) 的结局分析,需要TAVR后永久的PM植入.

主要成果:

需要TAVR后PM的患者年龄较大,男性更频繁,心房的发病率更高.
在1年的随访中,PM接受者表现出更高的全因 (aHR: 1.15) 和心血管死亡率 (aHR: 1.25).
显著增加的心血管死亡率,LVEF下降和NYHA类III/IV在1年后被观察到,在5年和10年持续较高的死亡率.

结论:

在TAVR后30天内植入心脏起器与总体和心血管死亡率大幅增加有关.
这些不良结果持续长达10年,突出显示需要PM后TAVR的患者监测的重要性.

关键词:

心血管死亡率心血管死亡率心脏衰竭是因为心脏衰竭.高度的心房静脉阻塞植入心脏起器的植入方式通过导管更换大动脉门.

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