在TAVR之后的心脏结构并发症
Silvia Mas-Peiro1, Guillem Muntané-Carol2,3, Julien Ternacle4
1Quebec Heart and Lung Institute, Laval University, Quebec City, Canada (S.M.-P., S.M., M.A., J.R.-C.).
Circulation. Cardiovascular interventions
|February 5, 2026
概括
心脏结构性并发症 (CSCs) 影响大约2%的透气管大动脉置换患者,死亡率和手术转换率高. 这些并发症并没有随着时间的推移而减少,因此需要进一步研究预防和管理.
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:
- 心脏结构性并发症 (CSCs) 根据门学术研究联盟3的共识定义为经过透气管大动脉置换 (TAVR) 后的关键周围过程事件.
- 了解CSC对于改善TAVR结果至关重要.
研究的目的:
- 评估CSC在当代TAVR程序中的发生率,时间,管理和临床影响.
- 为了评估10年内CSC的趋势.
主要方法:
- 一项多中心研究,涉及10541名在18个欧洲和加拿大中心接受TAVR的患者 (2014-2024年).
- CSCs根据门学术研究联盟3的标准进行分类,包括心脏结构妥协,新的心周溢血和冠状动脉阻塞.
- 患者数据以前性方式收集,并对患者进行长达一年的跟踪,然后每年进行一次跟踪.
主要成果:
- 2.1%的患者患有CSC,其中1.2%患有多重并发症.
- 最常见的CSC是心脏结构损伤 (1.4%) 和新心周溢血 (1.4%).
- 程序内事件 (75.6%) 经常需要转换为开放心脏手术 (27.6%),与35.3%的30天死亡率相关,特别是环状破裂 (41.0%).
结论:
- 在TAVR中,CSC仍然是一个重大问题,影响了大约2%的患者,十年来发生率没有下降.
- 这些并发症经常需要手术转换,并且与高死亡率有关.
- 进一步的研究对于开发预防策略和优化CSC的外科救助管理至关重要.
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