在混合的西弗斯1型双主动脉疾病中进行过导管主动脉干预
Andrea Zito1, Michele Galasso2, Won-Keun Kim3
1Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy; Valve Center, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy.
Revista espanola de cardiologia (English ed.)
|March 7, 2026
概括
双主动脉 (BAV) 狭窄的患者接受过管道主动脉植入 (TAVI),同时也患有中度或重度主动脉反 (AR),经历的重大不良事件较少. 这组混合的BAV疾病组与纯的BAV狭窄相比,死亡风险显著降低.
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:
- 双主动脉 (BAV) 狭窄是一种常见的先天性心脏缺陷.
- 过导管大动脉植入 (TAVI) 是严重的大动脉狭窄症的标准治疗方法.
- 基线大动脉反 (AR) 对BAV狭窄症TAVI结局的影响尚不清楚.
研究的目的:
- 在接受TAVI的Sievers1型BAV狭窄症患者中研究基线AR严重程度的预后意义.
- 为了比较纯BAV狭窄症患者和混合BAV疾病患者 (中度/重度AR的BAV狭窄症) 之间的临床结果.
主要方法:
- 一项多中心研究包括956名连续患有严重Sievers型1 BAV狭窄症的患者,接受TAVI治疗.
- 患者被分为"纯 BAV 狭窄" (无/轻度 AR) 和"混合 BAV 疾病" (中度/重度 AR) 组.
- 主要不良事件 (MAE),包括全因死亡,脑血管事件和心力衰竭住院治疗,使用调整后的Cox模型进行了比较.
主要成果:
- 134名患者 (14%) 患有混合BAV疾病,822名 (86%) 患有纯BAV狭窄症.
- 在1.2年的中位随访期内,混合BAV疾病患者的MAE风险明显降低 (9.0%与17.5%相比;调整后HR为0.47).
- 这种MAE的减少主要是由于混合BAV疾病组所有原因死亡风险较低 (6.0%对12.0%;调整HR为0.44).
结论:
- 在接受TAVI的Sievers1型BAV狭窄患者中,混合BAV疾病与改善的临床结果有关.
- 患有中度或重度AR并患有BAV狭窄症的患者在TAVI后有较低的重大不良事件和全因死亡风险.
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