紧急与选择性跨导管大动脉置换在患有严重大动脉狭窄症的患者中
Jennifer Y Zhou1, Shane Nanayakkara2, Rozanne Johnston3
1Department of Cardiology, Heart Centre, Alfred Health, Melbourne, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
JACC. Advances
|July 29, 2025
概括
紧急通过导管的大动脉置换 (TAVR) 是可行的,与选择性TAVR相似的30天存活率. 然而,紧急的TAVR与12个月死亡率的增加有关,需要长期改善的策略.
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
- 医疗保健服务研究 医疗服务研究
背景情况:
- 紧急通过导管的大动脉置换 (TAVR) 越来越多地用于急性大动脉狭窄.
- 对于紧急的TAVR存在有限的结果数据,特别是在低风险患者中.
研究的目的:
- 比较特点,程序成功和紧急与可选TAVR的结果.
- 在当代队列中评估紧急TAVR的短期和长期结果.
主要方法:
- 来自两个大体积中心 (2017-2023) 的1414名连续TAVR患者的回顾性分析.
- 主要结局:30天死亡率. 二次结果:手术成功,并发症,30天和12个月后的结果.
- 紧急 (n=127) 和可选TAVR组之间的比较.
主要成果:
- 紧急TAVR患者年轻,并且有更严重的门狭窄.
- 程序成功和门功能在各组之间是相似的.
- 紧急TAVR显示急性损伤和12个月死亡率较高,但调整后30天死亡率没有显著差异.
结论:
- 紧急TAVR显示了与可选TAVR相比的可比程序成功和调整后的30天死亡率.
- 紧急TAVR与12个月死亡率的增加有关,这表明需要长期优化结果战略.
- 这些发现支持紧急TAVR作为急性大动脉狭窄的可行短期解决方案.
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