动脉置换后的假肢-患者不匹配-全面的审查
Sriharsha Talapaneni1, Danial Ahmad1, Meghna Khandelwal1
1Division of Cardiac Surgery, Department of Surgery, Yale University School of Medicine, New Haven, CT 06510, USA.
Journal of clinical medicine
|December 30, 2025
概括
在主动脉置换 (AVR) 后,假肢患者不匹配 (PPM) 会对存活率产生负面影响. 通过精确的尺寸和门选择来预防PPM对于最佳的患者结果至关重要.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 生物医学工程 生物医学工程
背景情况:
- 假肢-患者不匹配 (PPM) 是大动脉置换 (AVR) 后的一个关键并发症.
- 当植入的有效孔面积不成比例地小于患者的身体大小时,就会发生PPM.
- 这种不匹配显著影响血液动力学,心脏重塑和长期生存.
研究的目的:
- 综合审查PPM的病理生理学,临床后果和治疗策略,无论是外科AVR (SAVR) 还是透导管AVR (TAVR).
- 综合目前关于PPM患病率,血液动力学影响,患者结果和缓解方法的证据.
主要方法:
- 进行了叙事审查,系统地搜索了PubMed和Embase数据库.
- 关键词包括"大动脉置换"和"假肢患者不匹配".
- 选了关键研究和评论,重点关注PPM患病率,血液动力学影响,临床结果和缓解策略.
主要成果:
- PPM的患病率有所不同 (5-30% SAVR,2-35% TAVR),通过指数有效孔面积 (iEOA) 值来定义.
- PPM与梯度增加,LV质量回归受损,冠状动脉流量问题,心力衰竭和死亡率有关.
- 新的TAVR和外科门显示PPM率较低;门内和生物假体门骨折提供了一些好处,但有局限性.
结论:
- PPM是AVR的一个常见的后果并发症,危及长期结果.
- 通过准确的手术前评估,门大小和潜在的环状扩大来预防是关键.
- 在初始程序期间优化门选择和预防PPM对于生存和未来的治疗选择至关重要.
更多相关视频
14:14Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
14.6K
05:31Transcatheter Pulmonary Valve Replacement from Autologous Pericardium with a Self-Expandable Nitinol Stent in an Adult Sheep Model
Published on: June 8, 2022
3.3K
相关概念视频
Aortic Regurgitation III: Medical Management
366
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
366
Mitral Valve Prolapse II: Assessment and Management
368
IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular...
368
Mitral Stenosis IV: Nursing Management
234
A comprehensive nursing assessment is essential for patients with valvular heart disease, which involves any dysfunction of the heart valves that could impact blood flow and overall heart function.Subjective Data Collection:Chief Complaint and Present Illness: Start with the patient's primary concerns, focusing on the onset, duration, and progression of cardiac symptoms such as dyspnea, fatigue, chest pain, and palpitations.Past Medical History: Collect detailed information on any previous...
234
Aortic Regurgitation I: Introduction
427
IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
427
