在TAVI (CAvEAT) 之后的冠状动脉接入研究:TAVR之后的CA的前性注册表
Giuseppe Tarantini1, Luca Nai Fovino1, Flavia Belloni2
1Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy.
JACC. Cardiovascular interventions
|June 25, 2025
概括
像SAPIEN 3/Ultra这样的短透管心脏 (THV) 在经过透管大动脉置换 (TAVR) 后提供了优越的冠状动脉接入. 高框架THV显示出不同的成功率,大型电池设计的表现优于封闭电池的设计.
科学领域:
- 干预心脏病学 干预心脏病学
- 心血管器械 心血管器械
- 结构性心脏病是一种心脏病.
背景情况:
- 透导管大动脉置换 (TAVR) 越来越多地在寿命较长的患者中进行.
- 预计TAVR后后续冠状动脉接入 (CA) 的需求将增加.
研究的目的:
- 评估TAVR后冠状动脉接入 (CA) 在四种不同的跨导管心脏 (THV) 类型的可行性.
- 为了比较不同THV设计之间的选择性CA率.
主要方法:
- 一个前性的多中心注册表 (CAvEAT) 录取了632名接受 transfemoral TAVR 的患者.
- 在TAVR后立即进行冠状动脉扫描,使用SAPIEN 3/Ultra,ACURATE neo/neo2,Portico/Navitor或Evolut Pro/Pro+ THVs.
- 主要终点是两个冠状动脉的成功选择性CA.
主要成果:
- 在89%的SAPIEN 3/Ultra,63%的ACURATE neo/neo2,62%的Portico/Navitor和45%的Evolut Pro/Pro+案例中获得了选择性CA.
- 与所有高THV相比,SAPIEN 3/Ultra显示了明显更高的选择性CA率 (P < 0.001).
- 在高框架THV中,大型细胞Portico/Navitor和ACURATE neo/neo2的表现优于封闭细胞Evolut Pro/Pro+.
结论:
- 短的SAPIEN 3/Ultra THVs提供了TAVR后的最高选择性冠状动脉接入率.
- 对于CA的高THV性能有所不同,大细胞设计比闭细胞设计显示出更好的结果.
- 植入深度, commissural 调整和 THV 框架类型独立地预测 CA 的成功.
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