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自扩张或气球可扩张的跨导管大动脉替换在患有小大动脉环的患者:一个系统的审查和元分析

Tanawat Attachaipanich¹, Kotchakorn Kaewboot², Suthinee Attachaipanich³

¹Department of Internal Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, MO, 64110, USA.

Indian heart journal

|November 17, 2025

概括

自扩展门 (SEVs) 减少了跨导管大动脉替换 (TAVR) 中的假肢患者不匹配,但与气球扩展门 (BEVs) 相比,增加了准门泄漏和起器植入的风险. 这两种门类型的生存率仍然相似.

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
生物医学工程生物医学工程

背景情况:

小的大动脉环在跨导管大动脉置换 (TAVR) 中带来了血液动力学挑战.
假肢-患者不匹配 (PPM) 和低于最佳的门性能是在患有小主动脉环的患者中增加的风险.
将自扩张 (SEV) 和气球可扩展 (BEV) 进行比较,对于优化这一群体的TAVR结果至关重要.

研究的目的:

为了比较SEVs与BEVs在TAVR患者的疗效和安全性,这些患者患有小主动脉环.
评估SEVs和BEVs之间的假肢患者不匹配 (PPM),门功能和程序并发症的差异.
确定门选择对这种特定患者群体的死亡率和长期结果的影响.

主要方法:

在PubMed,Embase,Web of Science和Cochrane CENTRAL数据库中进行系统的文献搜索.
包括38项研究,包括19,421名参与者,比较SEV和BEV在患有小大动脉环形患者中的研究.
对临床结果的分析,包括全因死亡率,PPM,膜外泄 (PVL) 和永久心脏起器植入 (PPI).

主要成果:

在长达5年的随访期间,SEV和BEV之间的所有原因死亡率没有显著差异.
特别服务车辆在排放,30天和1年时显示出明显较低的PPM率.
SEV与住院和中度至重度PVL的风险更高,永久心脏起器植入 (PPI) 的比率增加有关.

结论:

与BEV相比,SEV提供了血液动力学优势,并降低了与BEV相比的PPM风险,而不影响生存率.
与SEV一起增加PVL和PPI的风险需要仔细考虑.
基于患者解剖学和风险因素的个性化门选择对于优化TAVR结果至关重要.

关键词:

气球可扩展的门自扩展门的自扩展门小主动脉环小动脉环.通过导管更换大动脉门.

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