过导管和外科手术对象大动脉置换后的六年结果在患有大动脉狭窄症的低风险患者中
John K Forrest1, Steven J Yakubov2, G Michael Deeb3
1Yale University School of Medicine, New Haven, Connecticut, USA.
Journal of the American College of Cardiology
|February 16, 2026
概括
通过导管的大动脉置换 (TAVR) 显示,与低风险患者的手术相比,死亡率或中风的6年结果类似. 然而,TAVR的再干预率较高,主要是由于大动脉反.
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
- 手术创新 在外科创新.
背景情况:
- 进化低风险试验调查了低风险患者的严重大动脉狭窄.
- 每年随访评估10年死亡率,中风和二次终点.
研究的目的:
- 报告6年的临床结果,比较跨导管大动脉置换 (TAVR) 和手术大动脉置换.
- 由于观察到的再干预率,对7年数据进行额外分析.
主要方法:
- 随机试验的低风险患者严重的症状大动脉狭窄 (2016-2019).
- 使用Kaplan-Meier估计和日志等级测试进行预先规定的6年分析.
- 对现有数据进行了额外的7年分析,将再干预率作为累积发病率报告.
主要成果:
- 在6年后,综合所有原因死亡率或致残性中风 (23.3%的TAVR与20.4%的手术) 没有显著差异.
- 在6年后,TAVR (5.5%) 和手术 (3.3%) 的再干预率更高.
- 在7年后,TAVR重新干预率 (9.8%) 仍然高于手术 (6.0%),主要是大动脉吐.
结论:
- 在TAVR和手术之间,在6年死亡率或致残性中风方面没有显著差异.
- 与手术相比,TAVR在6年和7年都显示出更高的再干预率.
- 增加大动脉反是TAVR重新干预的主要驱动因素.
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