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可以在没有心脏外科手术的情况下进行TAVI吗?

V Lodo¹, C Barbero², S Salizzoni³

¹Department of Cardiac Surgery, Azienda Ospedaliera Ordine Mauriziano, Turin, Italy.

International journal of cardiology. Heart & vasculature

|July 16, 2025

概括

通过导管的大动脉植入 (TAVI) 期间发生的突发心脏手术 (ECS) 是罕见的 (0.74%),但可控. 现场的外科小组对于改善患者的治疗结果和降低TAVI手术中的死亡率至关重要.

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
心脏外科手术心脏外科手术

背景情况:

过导管大动脉植入 (TAVI) 是对大动脉狭窄的一种微创手术.
程序内并发症可能需要紧急的心脏手术 (ECS).
现场手术团队在管理这些并发症方面的作用至关重要.

研究的目的:

评估TAVI期间手术救助的发生率.
为了评估在TAVI后需要ECS的患者的术后结果.
确定现场心脏手术对TAVI结果的影响.

主要方法:

在2017年9月至2023年3月期间,对1347名患者进行了体输血TAVI的回顾性分析.
数据收集自两个高体积的中心与现场心脏外科手术.
主要终点:在ECS.之后的住院死亡率. 二级终点:手术期间和1年死亡率,以及像AKI,中风,MI和LBBB这样的并发症.

主要成果:

10名患者 (0.74%) 需要ECS由于并发症,包括大动脉剖析,环断裂和心室穿孔.
四名患者需要手术后的内性支持;一个患有中风和一个AKI (III级).
住院死亡率低 (一例),中位数ICU和住院时间分别为4.5天和14天.

结论:

现场心脏手术与专门的手术团队是TAVI中心的重要资源.
这种设置对于有效管理新出现的并发症至关重要.
现场手术团队的存在有助于在需要ECS的TAVI患者中实现低入院死亡率.

关键词:

紧急的心脏外科手术.在现场进行心脏手术.塔维 (Tavi) 是一个古老的城市.

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