跨导管大动脉置换后的新鼻腔洗时间和血液动力学结果
Shivabalan Kathavarayan Ramu1, Toshiaki Isogai1, Saksham Beotra1
1Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland, Ohio, USA.
Structural heart : the journal of the Heart Team
|September 2, 2025
概括
经过透气管大动脉置换 (TAVR) 后延长的新鼻洗时间与较高的梯度和低衰减的叶片加厚 (HALT) 有关. NWT可以预测TAVR功能障碍,指导早期治疗.
科学领域:
- 心血管医学
- 生物医学工程
- 医学成像
背景情况:
- 通过导管进行的大动脉置换 (TAVR) 会导致叶片血栓和功能障碍的风险.
- 延长的新鼻洗时间 (NWT) 与低衰减叶片加厚 (HALT) 和退化有关.
研究的目的:
- 通过计算机视觉获得的体内NWT与TAVR后的血液动力学结果之间的关联.
- 要确定NWT是否预测30天和1年的门不良事件.
主要方法:
- 用气球扩展进行TAVR的2254名患者的回顾性分析 (2016-2020年).
- 根据NWT (T1: 1. 444 - 1. 870s,T2: 1. 870 - 1.939s,T3: 1.939 - 2.110s) 进行分层的患者.
- 动脉图的计算机视觉分析以获得NWT;血液动力学参数和HALT的评估.
主要成果:
- 与T1 (p=0. 03) 相比,最高的NWT第三位 (T3) 在30天内显示出明显更高的跨膜大动脉的平均梯度.
- 在多变量分析中,T3独立地与大动脉平均梯度的增加有关 (p=0. 02).
- 在30天后,HALT患者的NWT显著增加 (p=0. 001),每增加0. 1秒的NWT就增加了HALT几率的三倍.
结论:
- 延长的NWT与更高的跨梯度有关,并且独立地预测TAVR后的HALT.
- NWT 作为一种潜在的新标志物,用于识别患有 TAVR 功能障碍的患者.
- NWT测量可以指导早期药物治疗以缓解变性.
相关概念视频
Cardiac Catheterization IV: Nursing Management
193
Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
193
Aneurysm IV: Nursing Management
20
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
20
Aortic Regurgitation II: Clinical Features and Diagnostic Tests
52
Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
52
Aortic Regurgitation III: Medical Management
42
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
42
Mitral Stenosis IV: Nursing Management
41
A comprehensive nursing assessment is essential for patients with valvular heart disease, which involves any dysfunction of the heart valves that could impact blood flow and overall heart function.Subjective Data Collection:Chief Complaint and Present Illness: Start with the patient's primary concerns, focusing on the onset, duration, and progression of cardiac symptoms such as dyspnea, fatigue, chest pain, and palpitations.Past Medical History: Collect detailed information on any previous...
41
Cardiomyopathy VII: Pre and Post Operative Nursing Management
27
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
27


