跨导管大动脉置换手术救助的发生率和结果
Daniel McGrath1, Charley Sun2, Michael Zhu2
1Department of Medicine, Tufts Medical Center, Boston, MA 02111, United States.
概括
过导管大动脉置换 (TAVR) 后的手术转换率略有增加,但转换后的死亡率显著下降. 这表明,尽管TAVR手术的增加需要突发性开放心脏手术,但结果有所改善.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 干预心脏病学 干预心脏病学
背景情况:
- 过导管大动脉置换 (TAVR) 是对大动脉狭窄的一种微创手术.
- 程序内并发症可能需要转换为开放心脏手术,这就需要现场手术团队的问题提出了问题.
- 了解这些转换的趋势和结果对于优化TAVR患者护理至关重要.
研究的目的:
- 调查美国TAVR后手术转换的发生率和结果.
- 分析随着时间的推移,转换率和相关死亡率的趋势.
- 确定转化和转化后死亡率的预测因素.
主要方法:
- 利用国家住院患者样本数据库 (2017-2021) 来识别TAVR患者.
- 定义转换为在TAVR后1天内进行的开放心脏手术.
- 比较患者的特征和结果,分析趋势,并确定预测因素.
主要成果:
- 在68,141名TAVR患者中,0.6%需要转换,发病率从0.50%上升到0.68%.
- 转换后的死亡率显著下降,从30.0%降至17.9%.
- 较年轻的患者,肝病,营养不良和类风湿性膜疾病与转化有关;心脏出血和心脏周周切开术的需要减少.
结论:
- 手术转换发生率增加,而在当代TAVR时代,转换后死亡率下降.
- TAVR患者的整体风险概况和严重的手术内心脏损伤的发生率有所减少.
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