对于65岁以下患者的严重大动脉狭窄症的单独和联合大动脉置换趋势
在PubMed上查看摘要
概括
此摘要是机器生成的。在患有主动脉狭窄症 (AS) 的年轻患者中,透气管主动脉置换 (TAVR) 的使用正在增加. 然而,当考虑所有手术,包括机械门和联合手术时,TAVR仍然比外科主动脉置换 (SAVR) 少.
科学领域
- 心血管医学
- 干预心脏病学
- 心脏外科
背景情况
- 在年轻患者 (65岁以下) 中,隔离性大动脉狭窄症患者中,透过导管的大动脉置换 (TAVR) 和外科大动脉置换 (SAVR) 的使用率接近平衡.
- 在整个主动脉置换 (AVR) 程序的采用趋势,包括机械 SAVR 和并发程序,仍然不清楚.
研究的目的
- 在接受AVR治疗严重AS的65岁以下患者中研究TAVR与SAVR的利用趋势.
- 在程序方法和患者共同疾病方面比较TAVR和SAVR (单独和组合).
主要方法
- 从2015年到2023年的多中心注册表 (北新英格兰心血管疾病组) 的回顾性分析.
- 包括1254名年龄在65岁以下的患者,他们接受了严重AS的AVR治疗.
- 通过AVR方法对患者进行分层:TAVR,单独的SAVR和联合的SAVR (同时进行的SAVR).
主要成果
- TAVR的使用率翻了一番,接近生物假肢SAVR的使用率 (2021-2023年为28.3%而不是30.8%).
- 在包括机械SAVR和组合SAVR时,TAVR总体占所有AVR程序的25%.
- 与SAVR组相比,TAVR患者的并发症负担较高.
结论
- 在AS的年轻患者 (65岁以下) 中,TAVR的使用量一直在增加,特别是那些患病并发症和风险较高的患者.
- 虽然近年来TAVR占AS单个病例的50%左右,但在所有AVR程序中,其总份额仍在25%左右.
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