在门中的门,环中的门和门年化中进行过导管中关替换后的结果
Chikashi Nakai1, Augustin DeLago2, Sanjay Samy1
1Department of Cardiothoracic Surgery, Albany Medical Center, Albany, New York.
概括
在故障的门 (ViV/ViR) 中,通过导管关替换 (TMVR) 显示出比在关环状化 (ViM) 中更好的中期结果. ViM手术与显著增加的死亡率有关,这凸显了需要仔细选择患者的必要性.
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 医疗器械
背景情况:
- 有限的数据存在于中期到长期的结果,在特定的场景:门在门 (ViV),门在环 (ViR) 和门在门的环状化 (ViM).
- 评估结果对于因化或故障本源/生物假体门而接受TMVR的患者至关重要.
研究的目的:
- 评估和比较接受TMVR的患者的术后结果和中期生存率.
- 具体来说,将ViV/ViR中的TMVR与ViM中的TMVR之间的结果进行比较.
主要方法:
- 一组82名患者在2016年3月至2024年7月期间使用SAPIEN 3门进行TMVR.
- 患者被分为两个组:ViV/ViR中的TMVR (n=47) 和ViM中的TMVR (n=35).
- 结果,包括早期死亡率和中期存活率,在两组之间进行了比较.
主要成果:
- 对于左心室外流通道阻塞,ViM组需要更多的心室隔膜切除 (31.4%对4.3%,P<.01).
- 早期住院死亡率在ViM组明显高 (34.5%对2.1%,P<.01).
- 与ViV/ViR组 (57.4%) 相比,ViM组 (24.3%) 的累积5年生存率明显较低. ViM独立地与中期死亡率的增加有关 (HR,2.58;P < .01).
结论:
- 在内或内环的场景中,通过透气管替换中枢,与内环状化相比,在短期和中期表现更好.
- 中心环状化为TMVR具有更高的风险概况,需要仔细考虑程序复杂性和患者选择.
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