在使用Evolut FX进行TAVI后对冠状动脉通道的评估:CANNULATE TAVR EXPANDED研究
Yohei Ohno1, Norihiko Kamioka1, Junichi Miyamoto1
1Department of Cardiology, Tokai University School of Medicine, Isehara, Japan.
概括
Evolut FX系统显示,经过透气管大动脉植入 (TAVI) 的冠状动脉管 (CC) 的成功率很高. 冠状动脉错位是影响CC成功的主要因素,突出其在TAVI程序中的重要性.
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
- 医疗器械技术 医疗器械技术
背景情况:
- Evolut FX是一款新的自我扩张的跨导管大动脉,旨在进行上安置.
- 这种设计可以在TAVI程序中改善 commissural alignment.
研究的目的:
- 为了评估TAVI之后冠状动脉管道 (CC) 的可行性,使用Evolut FX系统.
- 为了评估 commissural 和冠状动脉对齐对CC成功的影响.
- 用TAVI后的计算机断层扫描 (CT) 来分析发现.
主要方法:
- 在CANNULATE TAVR EXPANDED研究中,前性地招募了与Evolut FX一起接受血液输血TAVI的患者.
- 在门部署后进行了冠状动脉通道和血管造影.
- 在TAVI后的CT扫描中,评估了指导管和冠状动脉对齐,并根据ALIGN-TAVR联盟的标准对错对齐进行了分类.
主要成果:
- 冠状动脉通道非常成功:左冠状动脉 (LCA) 100%,右冠状动脉 (RCA) 96.7%.
- 中度至严重的指导管错位发生在13.5%的患者中,冠状动脉错位发生在20.6% (LCA) 和22.2% (RCA).
- 冠状动脉 misalignment显著增加了CC时间,并被确定为LCA和RCA的次优通道的关键预测因素.
结论:
- 使用Evolut FX系统植入透导管大动脉的实验表明冠状动脉管成功率很高.
- 在手术后经常观察到良好的关和冠状动脉对齐.
- 冠状动脉 misalignment 成为成功实现冠状动脉通道的困难最强的预测因素.
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