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Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
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无管与跨导管大动脉替换:倾向性匹配分析

Marie Lamberigts1, Bert Sarrazin1, Delphine Szecel1,2

  • 1Department of Cardiovascular Sciences, Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium.

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无置换的大动脉替换 (SU-AVR) 与透气管大动脉替换 (TAVR) 相比,显示出较少的副膜泄漏. TAVR提供了更好的血液动力学性能和更短的住院时间.

关键词:
大动脉门的更换大动脉门狭窄症倾向性得分匹配的比分匹配无动脉门的无置换术通过导管更换大动脉门.

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科学领域:

  • 心血管外科心血管外科
  • 干预心脏病学 干预心脏病学
  • 医疗器械技术 医疗器械技术

背景情况:

  • 大动脉置换是严重的大动脉狭窄的常见手术.
  • 无管的大动脉置换 (SU-AVR) 和透气管大动脉置换 (TAVR) 是最少侵入性的选择.
  • 使用倾向性得分匹配直接比较SU-AVR和TAVR对于了解患者的结果至关重要.

研究的目的:

  • 为了比较SU-AVR和TAVR之间的患者特征和术后结果.
  • 为了评估 SU-AVR 和 TAVR 后的血液动力学性能.
  • 评估倾向性得分匹配的队列中的并发症和死亡率.

主要方法:

  • 使用倾向分数匹配 (PSM) 来创建可比的患者组.
  • 分析了2017年10月至2022年6月期间接受SU-AVR或TAVR的患者队列.
  • 对手术后的结果进行了比较,包括死亡率,并发症和血液动力学参数.

主要成果:

  • 在PSM之后,分析了118对患者. 住院死亡率为SU-AVR的0%和TAVR的4.2% (p=0.063).
  • 在致残性中风,需要透析或永久心脏起器植入率方面没有发现显著差异.
  • TAVR显示了显著较低的跨假肢梯度,但中度或严重的偏膜泄漏率较高 (11%与0%,p<0.001).

结论:

  • TAVR提供了卓越的血液动力学性能和更短的住院时间,减少了对术后透析的需求.
  • SU-AVR手术与显著较少的副膜泄漏有关.
  • SU-AVR和TAVR都是可行的选择,在特定结果方面具有明显的优势.