美国气球扩展性大动脉置换的中期结果
Amar Krishnaswamy1, Amr E Abbas2, Vasilis C Babaliaros3
1Cleveland Clinic, Cleveland, Ohio, USA.
JACC. Cardiovascular interventions
|August 27, 2025
概括
在高风险患者中,大动脉置换 (AViV) 的安全性和耐久性与透气导管大动脉置换 (TAVR) 相当. 这表明AVIV可能是更广泛的患者群体的可行选择.
科学领域:
- 心血管医学
- 干预心脏病学
- 生物材料科学
背景情况:
- 动脉内置置换 (AViV) 适用于患有退化手术的患者,这些患者面临高或极高的手术风险.
- 目前的证据主要基于有限的随访时间的小型研究.
研究的目的:
- 使用当代气球可扩展 (BEV) 评估AViV治疗的中期结果.
- 在一大群患者中,将AViV结局与本源透导动脉置换 (TAVR) 相比较.
主要方法:
- 从STS/ACCTVT注册表中对BEV AViV患者 (2015年6月至2023年12月) 与本地TAVR患者的倾向匹配.
- 主要分析的重点是5年死亡率和中风率.
- 根据STS得分,BEV亚型和手术型 (带支架或没有支架) 的结果进行了二次分析.
主要成果:
- 总共分析了13,638个匹配对 (14,474个AViV,385,556个TAVR).
- 与TAVR相比,AViV在5年内死亡率 (43. 1% 与 55. 2%) 和中风率 (10. 5% 与 11. 8%) 显著降低.
- 在所有尺寸中,SAPIEN 3 Ultra RESILIA装置显示了改进的回声梯度;在无支架和有支架的手术之间没有观察到死亡或中风的显著差异.
结论:
- 这项大规模实践研究证实了AViV与TAVR相比在所有手术风险级别的安全性和耐用性.
- 这些发现支持考虑扩大AVIV治疗的适用范围.
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