跨导管大动脉复杂干预的当代发生率和程序量
Maxwell C Braasch1, Sophia R Pyeatte1, June He1
1Division of Cardiothoracic Surgery, Department of Surgery, Washington University in St Louis, St Louis, Missouri.
JAMA cardiology
|September 24, 2025
概括
超导管大动脉置换 (TAVR) 重新干预的数量,包括重复TAVR和TAVR爆发剂,正在增加. 重复TAVR通常在初始手术后的五年内进行,因此需要进一步研究最佳的再干预策略.
科学领域:
- 心血管医学 心血管医学
- 干预心脏病学 干预心脏病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 过导管大动脉置换 (TAVR) 是对大动脉狭窄的常见手术.
- 在TAVR后的重新干预,无论是通过重复TAVR还是TAVR扩散,都变得越来越频繁.
- 目前关于TAVR重新干预的发生率和数量的数据有限.
研究的目的:
- 评估当代的程序性发生率和复制TAVR和TAVR爆炸的数量.
- 分析TAVR重新干预的趋势随时间的推移.
- 为了比较TAVR的再干预量与SAVR的再干预量.
主要方法:
- 来自美国医疗保险和医疗补助服务中心虚拟研究数据中心 (2012-2024) 数据的回顾性分析.
- 包括接受TAVR或SAVR再干预的患者.
- 分类为重复 TAVR,TAVR 爆发器,门式 TAVR (ViV TAVR) 和重复 SAVR 组.
主要成果:
- 分析了超过410,000个TAVR和299,000个SAVR.
- 确定了2,374个重制TAVR和1,346个TAVR爆炸物.
- TAVR重新干预的发生率从2019年的0.17%增加到2023年的0.28%;重复TAVR在5年后的指数TAVR之外是常见的.
结论:
- 复制TAVR和TAVR爆炸物的年产量正在增加,特别是在最近几年.
- 重复TAVR经常在初始TAVR后的五年内进行.
- 需要进行进一步的研究,以确定个别患者的最佳TAVR再干预策略.
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