在患有超大大动脉年的患者中进行过导管大动脉置换:来自大型队列的见解
Ziad Arow1, Omar Oliva2, Laurent Bonfils2
1Groupe CardioVasculaire Interventionnel, Clinique Pasteur, Toulouse, France; Cardiology Department, Meir Medical Center, Tel Aviv university, Israel.
The American journal of cardiology
|December 31, 2025
概括
过导管大动脉置换 (TAVR) 对大型大动脉环安全. 与气球可扩展 (BEVs) 相比,自扩展 (SEVs) 在超大环形中显示出更高的抛膜漏率.
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:
- 过导管大动脉置换 (TAVR) 在患有大或超大大动脉环的患者中提出了挑战.
- 这些患者的结局通常不如较小环形患者的结局.
研究的目的:
- 评估TAVR在患有大大动脉环和超大大动脉环的患者中的周围手术和临床结果.
- 在这个患者队列中,比较气球膨胀 (BEV) 和自我膨胀 (SEV) 之间的结果.
主要方法:
- 对237名接受TAVR治疗的患者进行回顾性分析,这些患者患有严重的大动脉狭窄,大或超大环形.
- 在BEVs (n=160) 和SEVs (n=77) 之间的结果比较.
- 主要终点包括设备的成功,中度/较大的准膜泄漏 (PVL),永久心脏起器 (PPM) 植入,新的左捆分支阻塞 (LBBB),中风和死亡率.
主要成果:
- 设备的整体成功率很高,而SEV的成功率较低 (84%对93%,p=0.034) 的趋势在多变量分析后并不显著.
- 中等或更大的PVL在SEV中更为频繁 (13%对4%,p=0.016),特别是在超大环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形环形
- 在门类型之间,一年死亡率 (13%的SEV与12%的BEV),PPM,LBBB,中风和并发症率相似.
结论:
- TAVR是一种可行且安全的手术,用于患有大大动脉环和超大大动脉环的患者.
- 在SEV患者中观察到中度或较大的PVL的更高率,这些患者具有超大环形.
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