在Tricuspid TEER后进行过导管三管替换和CLEFT
John T Saxon1, Dhiren Rajagopal2, Scott Tyler3
1University of Virginia Medical Center, Charlottesville, Virginia, USA.
JACC. Cardiovascular interventions
|October 25, 2025
概括
在经过三管边缘到边缘修复 (T-TEER) 后,通过三管三管置换 (TTVR) 有效地减少三管吐 (TR) 并改善心力衰竭症状. 这项研究表明,在T-TEER后重症TR患者中,TTVR的技术成功率和生存率很高.
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:
- 严重的三回 (TR) 显著增加死亡率和心力衰竭症状.
- 虽然跨导管三边缘边缘修复 (T-TEER) 提供了症状缓解,但低于最佳的结果需要进一步的干预.
- 在T-TEER之后的跨导管三门置换 (TTVR) 是一个新兴的选择,但它的短期结果和技术考虑需要详细评估.
研究的目的:
- 描述过导管三管置换 (TTVR) 的技术和结果,这些患者先前接受过导管三管边缘到边缘修复 (T-TEER) 治疗.
- 评估T-TEER后TTVR的可行性和安全性,包括使用电外科手册修改 (CLEFT) 的使用.
主要方法:
- 这项研究涉及16名患有严重TR后T-TEER的患者,他们使用EVOQUE门进行了TTVR.
- 技术包括使用算法进行程序规划,在某些情况下,剪辑自由化以促进TTVR (CLEFT).
- 主要结局是程序技术成功;次要结局包括30天死亡率,TR严重程度和NYHA功能类.
主要成果:
- 在93.7%的患者 (16人中15人) 中,程序技术成功.
- 30天的存活率为93.7% (16中的15个).
- 在30天内,在NYHA功能类 (86.7%在I/II类) 和TR严重程度 (93.3%没有或轻度TR) 中观察到显著改善.
结论:
- 经过三管边缘到边缘修复 (T-TEER) 后的跨管三管置换 (TTVR) 是严重的TR的一个可行的选择.
- 该程序,包括电外科手册修改,在30天后表现出高度的技术成功和显著的症状缓解.
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