通过导管或无/快速部署的大动脉替换? 来自个体患者数据元分析的当代见解
Jae-Sung Choi1, Jong-Ho Park2, Se Jin Oh1
1Department of Thoracic and Cardiovascular Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea.
无管/快速部署的大动脉置换 (SUAVR) 显示出比跨导管大动脉置换 (TAVR) 更好的长期存活率和早期结果. 然而,TAVR的平均压力梯度较低. 患者的选择是最佳结果的关键.
科学领域:
- 心血管外科心血管外科
- 干预心脏病学 干预心脏病学
- 生物医学工程 生物医学工程
背景情况:
- 过导管的大动脉置换 (TAVR) 和无/快速部署的大动脉置换 (SUAVR) 已经取得了显著的进展.
- 对于TAVR和SUAVR之间的长期结果,存在有限的比较数据.
研究的目的:
- 为了比较TAVR与SUAVR的长期结果.
- 为TAVR和SUAVR的疗效和安全提供最新的元分析证据.
主要方法:
- 更新的倾向性得分匹配研究的元分析.
- 从数字化卡普兰-梅尔曲线中重建个体患者数据 (IPD).
- 从14项研究中对6604名匹配患者进行了聚合分析和元回归.
主要成果:
- 与TAVR相比,SUAVR显示出更高的长期存活率 (64.6%与9年52.5%相比) 和较低的30天死亡率.
- TAVR与较低的平均压力梯度相关,但永久心脏起器植入率较高,并有中度至较大的膜漏洞.
- 超回归表明,由于PPI,假肢患者不匹配和PVL等因素,SUAVR的生存优势可能会被削弱.
结论:
- 与TAVR相比,SUAVR提供了优越的长期存活率和有利的早期结果.
- 在平均压力梯度方面,TAVR显示出了优势.
- 对于TAVR与SUAVR来说,个性化的患者选择至关重要,特别是在预期寿命较长的患者中.
更多相关视频
09:57Four-Dimensional Computed Tomography-Guided Valve Sizing for Transcatheter Pulmonary Valve Replacement
Published on: January 20, 2022
05:31Transcatheter Pulmonary Valve Replacement from Autologous Pericardium with a Self-Expandable Nitinol Stent in an Adult Sheep Model
Published on: June 8, 2022
相关概念视频
Contemporary Psychology
Biopsychology
Biopsychology, also known as biological psychology or behavioral neuroscience, focuses on the biological underpinnings of behavior and mental processes. It...
Analysis of Population Pharmacokinetic Data
Data Reporting and Recording
Impact of Individuals on Individuals
Heart Valves
The AV valves prevent the backflow of blood from the ventricles to the atria during ventricular contraction. These valves function with the assistance of the chordae tendineae and papillary muscles. When the ventricles are relaxed, the chordae tendineae are slack, allowing blood to flow from the atria into the...
Directing Effect of Substituents: meta-Directing Groups
