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通过导管或通过手术更换双门静脉

Joseph Kassab¹, Parth Desai¹, Neil Keshvani¹

¹Division of Cardiovascular Medicine, Department of Internal Medicine, UT Southwestern Medical Center, 2001 Inwood Road Suite WC05.870, Dallas, TX 75390-9254, USA.

European heart journal open

|September 2, 2025

概括

通过导管的动脉置换 (TAVR) 和手术的动脉置换 (SAVR) 在双动脉狭窄的患者中显示了类似的2年结果. 这些发现表明TAVR对于精心挑选的BAV患者来说是一个可行的选择.

科学领域:

心血管医学
干预心脏病学
心脏外科

背景情况:

双主动脉狭窄患者被排除在主要的透管主动脉置换 (TAVR) 试验之外.
在这种特定人群中,对TAVR和外科动脉置换 (SAVR) 的数据有限.

研究的目的:

在患有BAV狭窄症的患者中比较TAVR与SAVR的实际风险调整结果.
评估TAVR在BAV狭窄症患者中的安全性和有效性.

主要方法:

使用TrinetX数据库对经过单独TAVR或SAVR的成人 (≥18岁) 进行回顾性队列分析.
使用倾向分数匹配 (1:1) 来平衡患者的共变量.
主要结局包括2年全因死亡率,中风和门再干预.

主要成果:

在倾向性得分匹配 (663对) 后,2年全因死亡率相似 (TAVR: 4. 8% vs SAVR: 5. 3%; P=0. 71).
在TAVR和SAVR之间,中风的发生率相似 (TAVR: 7. 3%与SAVR: 4. 5%;P=0. 058).
门再干预率低且相似;TAVR显示了更高的起器植入率,但急性损伤和出血率较低.

结论:

在倾向匹配的BAV狭窄患者中,TAVR和SAVR显示出可比的2年死亡率,中风和重复干预率.
这些结果支持TAVR作为适当选择的BAV患者的可行治疗选择.
需要进一步的前性研究来验证这些发现.

关键词:

双动脉狭窄症美国一个 TAVR

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