当正确不是正确的时候:EVOQUE跨导管三巴替换系统的左大腿接口
Antonio H Frangieh1, Mark W Abdelnour1, Siddharth Vad2
1Mary & Steve Wen Cardiovascular Division, University of California Irvine, Irvine, California, USA.
Structural heart : the journal of the Heart Team
|October 13, 2025
概括
由于心脏的复杂解剖学,左转门接入是一个可行的替代方案,可以替换透气管三门,而右转门接入是具有挑战性的. 这种方法可以在困难的情况下提高门部署的成功率.
科学领域:
- 心血管干预 心血管干预
- 医疗成像医学成像
- 解剖学研究 解剖学研究
背景情况:
- 越来越多地使用EVOQUE系统的跨导管三门替换 (TTVR).
- 在患有特定右心脏解剖学的患者中,标准的右转移 (TF) 接入可能是困难的,这会影响手术的成功.
- 复杂的解剖学包括低右心房 (RA) 高度和大下静脉腔-三管环 (IVC-TVA) 偏移.
研究的目的:
- 评估左转管 (TF) 接入为TTVR的右转管 (TF) 接入的替代方案.
- 为了确定影响访问网站选择的解剖学因素.
- 在具有挑战性的解剖病例中评估左侧TF访问的可行性和有效性.
主要方法:
- 对现实世界临床场景的审查,在TTVR中使用左侧TF访问.
- 术前心脏计算机断层扫描血管学 (CCTA) 用于评估解剖学参数,如RA高度,小册子绑定,RV深度和乳头肌肉位置.
- 分析与左侧TF访问相关的程序结果和技术考虑.
主要成果:
- 左侧TF接入提供了更大的RA高度和更有利的门部署轨迹.
- 这种方法对具有较大的短轴 (SAX) 偏移或的长轴角度的患者尤其有益.
- 左侧TF接入可以克服与右侧TF接入在复杂解剖学中所见的低最佳同轴性和难以部署门所带来的挑战.
结论:
- 左侧TF接入是TTVR的安全和有效策略,用于特定患有解剖学上具有挑战性的右侧心脏结构的患者.
- 它扩大了程序的可行性,并且可能在正确的TF访问不足于最佳的情况下改善结果.
- 需要进一步的研究来评估长期结果,并指导下一代TTVR系统的开发.
相关概念视频
01:24Cardiac Catheterization III: Left Heart Catheterization
577
Left heart catheterization is an invasive diagnostic procedure used to evaluate the function and structure of the left side of the heart. It is generally performed to diagnose and treat cardiovascular conditions such as valve abnormalities, coronary artery disease, and congenital heart defects.Diagnostic and therapeutic purposesLeft heart catheterization serves various diagnostic and therapeutic purposes, including:Assessing coronary artery bypass grafts.Evaluating coronary artery disease in...
577
01:21Cardiac Catheterization II: Right Heart Catheterization
811
Right Heart Catheterization: An OverviewRight heart catheterization is an invasive diagnostic procedure that measures right-sided cardiac and pulmonary artery pressures, calculates cardiac output, and identifies intracardiac shunts. It provides detailed hemodynamic data essential for diagnosing and managing various cardiovascular conditions, such as pulmonary hypertension.Access SitesCommon access sites for right heart catheterization include the internal jugular vein in the neck region, the...
811
01:26Cardiac Catheterization IV: Nursing Management
644
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...
644
01:28Cardiac Catheterization I: Pre-Procedure Overview
1.1K
Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
1.1K
01:23Oxygen Delivering System III: Tracheostomy and T-piece
5.5K
Oxygen delivery is critical in clinical care, especially for patients with respiratory disorders or those undergoing surgical procedures. Various systems, such as tracheostomy and the T-piece, deliver oxygen to the lungs, ensuring adequate arterial oxygenation.
Tracheostomy
A tracheostomy is a surgically created opening (stoma) in the anterior part of the trachea. It is used to establish a patient airway, bypass an upper airway obstruction, simplify the removal of secretions, permit long-term...
Tracheostomy
A tracheostomy is a surgically created opening (stoma) in the anterior part of the trachea. It is used to establish a patient airway, bypass an upper airway obstruction, simplify the removal of secretions, permit long-term...
5.5K
01:29Venous Thrombosis III: Interprofessional Care
280
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
280