在 Evolut FX 和 Navitor 门之间冠状动脉对齐的差异.
Hioki Hirofumi1, Yamamoto Masanori2,3, Ochiai Tomoki4
1Department of Cardiology, IMS Tokyo Katsushika General Hospital, Tokyo, Japan.
概括
与内自扩充门 (IA-SEV) 相比,超内自扩充门 (SA-SEV) 在过导管大动脉替换 (TAVR) 后显示出明显较低的冠状动脉重叠,确保了未来更好的冠状动脉接入.
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
- 医疗成像医学成像
背景情况:
- 冠状动脉接入对于长期的患者管理中至关重要 跨导管大动脉置换后 (TAVR).
- 有限的数据存在于冠状动脉对齐与当前的超环状 (SA) 和内环状 (IA) 自扩张 (SEV).
研究的目的:
- 为了评估和比较TAVR后的冠状动脉对齐,使用SA-SEV与IA-SEV.
- 为了分析冠状动脉重叠和骨质几何学与跨导管心脏 (THV) 框架的关系.
主要方法:
- 对250个SA-SEV和152个IA-SEV TAVR病例进行了回顾性分析.
- 评估冠状动脉重叠 (CO) 通过新委托到冠状动脉骨架角度.
- 使用垂直和水平距离THV框架对冠状动脉几何学的评估.
主要成果:
- 与IA-SEV相比,SA-SEV的严重CO率明显较低 (LCA:10%与42%相比;RCA:12%与34%相比).
- 在SA-SEV (LCA: 3.3mm与8.0mm相比;RCA: 4.4mm与9.0mm相比) 中观察到,从冠状动脉骨到外围的垂直距离较短.
- 在SA-SEV中,冠状动脉骨和THV框架之间的水平距离更宽 (LCA:4.8mm与3.8mm相比;RCA:5.4mm与4.4mm相比).
结论:
- 在SA-SEV和IA-SEV平台之间存在冠状动脉重叠和骨质几何学的显著差异.
- 在TAVR后优化未来的冠状动脉接入可能取决于平衡解剖因素和设备特定的几何结构.
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