转导管大动脉置换后重复干预:重新转导管大动脉置换和外科扩展器的临床特征和结果
Gustavo Mendez-Hirata1, Christian W Schmidt1, Geoffrey A Answini1
1Lindner Center for Research and Education, The Christ Hospital Heart and Vascular Institute, Cincinnati, Ohio, USA.
Structural heart : the journal of the Heart Team
|June 18, 2025
概括
在跨导管大动脉置换 (TAVR) 后重复干预并不常见. 结构的恶化往往导致TAV在TAV程序中的TAV,而传染性内心炎通常需要手术.
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
- 人造心脏门是一种假心脏门.
背景情况:
- 越来越多地使用过导管大动脉 (TAV),但TAVR后重复干预的数据仍然有限.
- 交通运输系统的退化需要了解长期结果和重新干预策略.
研究的目的:
- 为了比较TAV中TAV的临床特征和结果与初始TAVR后的外科扩展手术程序.
- 分析TAVR后重复干预的频率和时间.
主要方法:
- 从2015年1月到2023年8月接受TAVR的1314名患者的回顾性分析.
- 包括31名需要重复干预的患者 (2,3%) (25名TAV在TAV中,6名外科扩张).
- 患者人口统计数据,重新干预的原因和不良事件的比较.
主要成果:
- 重复干预的中位时间是TAV中TAV的5.02年和外科外科外科的2.55年.
- 结构的恶化是TAV中TAV的主要原因 (60%),而感染性内心炎则在外科实验中占主导地位 (50%).
- 出院时主要不良心血管事件的发生率相似 (20%对17%);没有观察到扩散患者的死亡率.
结论:
- 在TAVR后的第一个十年内,重复干预很少发生.
- TAVR失效的机制决定了重新干预的选择:用于结构恶化的TAV中的TAV,用于内心炎的外科扩容剂.
- 了解故障模式对于指导TAVR之后的后续管理策略至关重要.
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