基础 Septal 缩对 TAVR 结果的影响:来自大型队列研究的证据
Ziad Arow1,2, Omar Oliva1, Juri Iwata1
1Clinique Pasteur, Toulouse, France.
概括
在接受过导管大动脉置换 (TAVR) 的患者中,基础隔膜缩 (BSH) 与扩张后,准膜泄漏和起器植入的风险增加有关. 轻微的隔膜加厚没有显著的影响.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心脏外科手术 心脏外科手术
背景情况:
- 基本隔膜缩 (BSH) 经常在接受过导管大动脉置换 (TAVR) 的老年患者中观察到.
- BSH对TAVR结局的临床影响尚未得到充分证实.
研究的目的:
- 调查BSH对接受TAVR的患者周围和术后结果的影响.
- 根据隔膜缩和门类型的严重程度来比较结果.
主要方法:
- 对3261名通过气球可扩展 (BEV) 或自扩展 (SEV) 进行TAVR的患者进行了回顾性分析.
- 患者根据基底隔膜厚度 (≥15毫米与<15毫米) 分类为组.
- 分析了包括围绕程序干预,程序成功和并发症在内的结果,并根据设备生成和门类型对子组进行了分析.
主要成果:
- 与那些没有显著的BSH患者相比,患有BSH (≥15毫米) 的患者表现出更高的扩张后发病率 (25%与21%),中度或更大的膜漏洞 (PVL) (2.4%与0.8%) 和永久心脏起器 (PPM) 植入 (18%与14%).
- 患有BSH的患者的自我扩张门 (SEV) 显示了特别高的扩张后,PVL和PPM植入率.
- 轻微的隔膜加厚 (12-15毫米) 并没有显著影响结果.
结论:
- 在TAVR之后,BSH (≥15毫米) 与扩张后,PVL和PPM植入率的增加有关.
- 这种关联在接受SEVs的患者中更为明显.
- 轻微的隔膜加厚似乎不会显著影响TAVR的结果.
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