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在患有严重化大动脉的患者中,自扩张的内透导管大动脉置换系统

Andrea Ruberti¹, Giovanni Occhipinti², Matias Mon³

¹Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Catalunya, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalunya, Spain; Facultat de Medicina i Ciencies de la Salut, Universitat de Barcelona (UB), Barcelona, Spain. Electronic address: https://x.com/a_rubi_5.

The Canadian journal of cardiology

|September 22, 2025

概括

严重的大动脉结石化 (AVC) 不会影响通过自扩张的内膜进行跨导管大动脉置换 (TAVR) 的结果. 患有严重AVC的患者有类似的30天设备成功,但更高的12个月心力衰竭住院治疗.

科学领域:

心脏病学心脏病学
干预心脏病学干预心脏病学
生物材料科学生物材料科学

背景情况:

严重的大动脉结石化 (AVC) 给跨导管大动脉置换 (TAVR) 带来了挑战.
在患有严重心脏中风的患者中,使用自扩张的内通气管心脏 (THVs) 的TAVR的结果尚未得到充分证实.
评估AVC严重程度对TAVR结果的影响对于患者选择和程序规划至关重要.

研究的目的:

为了评估严重的AVC对接受TAVR的患者的程序和临床结果的影响.
为了比较严重AVC (≥3000Agatston单位) 和非严重AVC (<3000Agatston单位) 的患者之间的结果.
在高风险人群中评估自我扩张的年内THV的性能.

主要方法:

这是一项回顾性多中心研究,涉及使用 Portico 或 Navitor THV 治疗的患者.
患者被分为严重的AVC (≥3000AU) 和非严重的AVC (<3000AU) 组.
主要终点是30天的设备成功;次要终点包括手术成功,心脏起器植入和12个月的临床结果.

主要成果:

严重的AVC与更高的AVC密度和平均跨膜梯度有关.
在严重和不严重的AVC组之间,30天设备的成功率相似 (89.7%与89.6%).
严重的AVC患者的手术预延长率较高,并且增加了永久心脏起器植入的趋势. 尽管门性能相似,但在严重的AVC组,12个月心力衰竭住院的病例显著增加 (13.8%与3.8%相比). 与Navitor THV相比,Portico THV显示设备故障的风险更高.

结论:

自扩张的年内THV对患有严重AVC的患者来说是有效和安全的.
即使有严重的化,也可以实现可比的程序成功和30天设备成功.
虽然门性能相似,但在严重的AVC患者中,12个月的心力衰竭住院的增加需要进一步调查和监测.

关键词:

导航员是一个导航员.门廊 (Portico) 是一个门廊.大动脉膜化化在内,内内.它是自我扩张的.通过导管更换大动脉门.

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