通过导管更换大动脉,以治疗大动脉新囊化后结构的恶化
Natsuko Satomi1, Masaki Miyasaka1,2, Yusuke Enta1
1Department of Cardiology, Sendai Kousei Hospital, Miyagi, Japan.
概括
透气管大动脉置换 (TAVR) 在大动脉新囊化 (AVNeo) 后,对于结构的恶化 (SVD) 是可行的. 需要仔细规划,以避免诸如深部植入或环断裂之类的并发症.
科学领域:
- 心血管外科心血管外科
- 干预心脏病学 干预心脏病学
- 生物材料科学 生物材料科学
背景情况:
- 有限的证据表明,在主动脉新囊化 (AVNeo) 后,结构的恶化 (SVD) 是存在的.
- 过导管大动脉置换 (TAVR) 是一种不那么侵入性的替代方案,但其在这种情况下的适用性尚未确立.
研究的目的:
- 在以前接受过AVNeo的患者中描述SVD.
- 评估TAVR在AVNeo后SVD患者的可行性和结果.
主要方法:
- 在AVNeo后对SVD进行TAVR的11名患者的回顾性分析.
- 将患者分为大动脉狭窄症 (AS-SVD) 和大动脉吐 (AR-SVD) 组.
- 评估手术成功,并发症和解剖学参数.
主要成果:
- 与AR-SVD组相比,AS-SVD组从AVNeo到TAVR的间隔较短,大动脉环面积较小.
- 塔弗在技术上取得了91%的成功. 尽管人们担心长时间的传单,但没有出现冠状动脉阻塞.
- 并发症包括一例第二门植入,两例新的导电干扰,以及一例大动脉含裂.
结论:
- 观察到AS-SVD的快速进展和AR-SVD的晚期发病表明需要进一步研究AVNeo的耐用性.
- 在AVNeo之后,TAVR是SVD的可行的治疗选择.
- 对冠状动脉阻塞的预防措施可能不是必不可少的;基于CT的准确基底环测定对于最佳的TAVR结果至关重要.
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