在ACURATE neo2中PVL用于跨导管大动脉更换的自我扩张的大动脉假体 - 一个多中心的回顾性注册分析
Lucca Loretz1, Won-Keun Kim2, Ole de Backer3
1Heart Center Lucerne, Luzerner Kantonsspital, Lucerne, Switzerland.
International journal of cardiology
|May 30, 2025
概括
植入深度高和指导管 misalignment 预测在ACURATE neo2 门的准膜泄漏 (PVL). 优化植入技术可以减少通过导管的大动脉替换 (TAVR) 后的PVL.
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:
- 在ACURATE neo2大动脉假体有一个延长的密封子,以最大限度地减少手术后的膜泄漏 (PVL).
- 关于特定的植入技术是否可以进一步减少PVL的数据有限.
- 这项研究调查了在ACURATE neo2植入后PVL的预测因素,重点是程序技术.
研究的目的:
- 在ACURATE neo2跨导管大动脉置换 (TAVR) 后,识别准膜泄漏 (PVL) 的预测因素.
- 评估植入技术对PVL率的影响.
- 为优化TAVR程序和改善患者治疗结果提供见解.
主要方法:
- 在三个中心对901名接受ACURATE neo2 TAVR治疗的患者进行了回顾性注册表分析.
- 患者被分为两组:无/痕迹PVL和轻度或更大的PVL (PVL≥轻度).
- 进行了统计分析,以确定PVL的显著预测因素.
主要成果:
- 在67%的患者中,PVL被评为无/微量,在32%的患者中轻度,在1%的患者中中度.
- 对于PVL ≥轻度的显著预测因素包括植入深度 (OR 0.93每毫米) 和 commissural misalignment >45° (OR 9.6).
- 其他预测因素是LVOT化严重程度 (OR 1.98),管结直径 (OR 1.08每毫米) 和Valsalva鼻直径 (OR 1.07每毫米).
结论:
- 在ACURATE neo2植入后,高植入深度和显著的委托点错位与中度或严重的PVL有关.
- 这些发现强调了精确的植入技术的重要性,以尽量减少PVL.
- 优化植入策略可能会改善TAVR患者的临床结果.
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