大动脉狭窄症相关心脏损伤:通过手术治疗的患者和透气管大动脉置换的患者之间的比较
Ricardo Román1, Fabián Islas2, Patrick O'Neill-González1
1Instituto Cardiovascular, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
Journal of clinical medicine
|March 14, 2026
概括
由于严重的大动脉狭窄症 (AS) 进行过透管大动脉置换 (TAVR) 的患者比手术大动脉置换 (SAVR) 患者表现出更广泛的心脏损伤. 在晚期损伤之前的早期干预可能会改善结果.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 干预心脏病学 干预心脏病学
背景情况:
- 严重的大动脉狭窄 (AS) 可以导致额外膜心脏损伤.
- 这种损伤与大动脉干预后患者的结果有关.
研究的目的:
- 为了比较AS相关的心脏损伤的外科动脉置换 (SAVR) 和透气管动脉置换 (TAVR) 患者.
- 分析心脏损伤阶段对干预后1年死亡率的影响.
主要方法:
- 874名患有严重AS的患者进行SAVR或TAVR (2017-2022) 的回顾性分析.
- 干预前临床和心声学参数的比较.
- 使用Généreux和Gutiérrez-Ortiz分期系统对心脏损伤的患者的分类.
- 基于损伤阶段的1年全因死亡率的评估.
主要成果:
- TAVR患者年龄较大,女性更常见,并且手术风险比SAVR患者高.
- 根据两种分期系统,TAVR患者与SAVR患者相比,心脏损伤 (右侧) 显著更先进.
- 在右侧损伤的患者中观察到较高的死亡率,无论干预类型或分期系统如何.
结论:
- 与SAVR患者相比,接受TAVR治疗的当代严重症状AS患者出现了更广泛的心脏损伤.
- 这凸显了干预时间的重要性,特别是对于TAVR候选人.
- 晚期心脏损伤之前的早期干预可能会改善患者的治疗结果.
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