贝叶斯的超导管对比的贝叶斯的元分析与手术大动脉替换在小大动脉环的患者
Vinícius Martins Rodrigues Oliveira1, Maria Elisa Passos Nishikubo1, Ana Gabrielly Oliveira Antunes1
1Department of Medicine, Federal University of Goiás, Goiânia, Brazil.
概括
通过导管的大动脉置换 (TAVR) 减少了小大动脉环 (SAA) 患者的患者假体不匹配. 然而,手术性大动脉置换 (SAVR) 的风险较低,大动脉吐和心脏起器植入的风险较低.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心脏外科手术 心脏外科手术
背景情况:
- 小主动脉环 (SAA) 与主动脉置换后的不良结果有关.
- 在SAA患者中对大动脉疾病的最佳治疗策略仍未确定.
研究的目的:
- 为了在SAA患者中比较跨导管大动脉置换 (TAVR) 与手术大动脉置换 (SAVR).
- 评估TAVR与SAVR的风险和益处,包括患者与假肢不匹配,大动脉吐,心脏起器植入,中风和死亡率.
主要方法:
- 进行了系统性审查和贝叶斯随机效应元分析.
- 分析了9项涉及2548名患者的研究.
- 用二项-正常等级模型合成结果,以估计治疗效果和确定性.
主要成果:
- TAVR显著降低了严重和中度患者假肢不匹配 (PPM) 的风险.
- SAVR与中度/重度大动脉吐和永久心脏起器植入的风险较低有关.
- 对于30天中风或1年的全因死亡率,TAVR和SAVR之间没有发现显著差异.
结论:
- 在SAA患者中,TAVR在缓解患者与假肢不匹配方面表现出优于SAVR的优势.
- 与TAVR相比,SAVR与大动脉吐和新心脏起器植入的风险降低有关.
- 在这个患者队列中,TAVR和SAVR都没有显示出中风或死亡率的显著差异.
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