跨导管大动脉植入后的非心脏手术
Amir Geressu1, Robert T Sparrow1,2, Santiago García3
1London Health Sciences Centre, London, Ontario, Canada.
European heart journal. Quality of care & clinical outcomes
|August 4, 2025
概括
过导管大动脉植入后的非心脏手术 (TAVI) 不常见,死亡率低. 诸如心力衰竭和糖尿病等疾病增加了不良事件风险,而不是手术风险本身.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 老年医学 老年医学
背景情况:
- 有限的数据存在于经过透气管大动脉植入 (TAVI) 后接受非心脏手术 (NCS) 的患者的术后结果.
- 了解这些结果对于管理需要随后NCS的TAVI患者至关重要.
研究的目的:
- 为了确定TAVI后可选NCS的发病率,手术类型,时间和术后结果.
- 在这个患者群体中确定与重大不良事件 (MAE) 相关的因素.
主要方法:
- 对美国国家再接收数据库 (2012-2021) 分析TAVI后六个月内接受NCS的患者.
- 评估的结果包括住院MAE (死亡,心脏并发症,中风/TIA).
- 多变量回归模型确定了MAE的独立预测因素.
主要成果:
- 在502,775名TAVI患者中,0.48%的患者在6个月内接受了选择性NCS.
- 总体MAE率为7.6%,在低,中等或高手术风险组之间没有显著差异.
- 心脏并发症是MAE的主要驱动因素;死亡率很低,在各个风险组中相似.
- MAE的独立预测因素包括充血性心力衰竭,肝病,糖尿病,癌症和再入院时间.
结论:
- 在TAVI之后选择性NCS是罕见的,并与低死亡率相关.
- 手术风险水平没有影响手术后的不良事件;然而,之前存在的条件和手术的时间是显著的.
- 对NCS后TAVI的决定需要平衡手术风险与推迟手术的风险.
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