Heart:主动脉狭窄失代偿急诊患者该如何治疗?

2017-12-28 MedSci MedSci原创

对于急性严重的主动脉狭窄失代偿患者的最佳治疗方案尚存争议。本研究的目的旨在比较评估急诊主动脉瓣经导管置换术(eTAVI)和急诊主动脉瓣球囊扩张术(eBAV)的早期预后。本研究将急诊主动脉狭窄失代偿定义为:需要儿茶酚胺治疗的心源性休克,严重的急性呼吸困难,心脏复苏或者机械呼吸支持治疗。在德国5个临床研究中心中,共有23例患者接受了eTAVI治疗,118例患者接受了eBAV治疗。在eTAVI治疗组,术

对于急性严重的主动脉狭窄失代偿患者的最佳治疗方案尚存争议。本研究的目的旨在比较评估急诊主动脉瓣经导管置换术(eTAVI)和急诊主动脉瓣球囊扩张术(eBAV)的早期预后。

本研究将急诊主动脉狭窄失代偿定义为:需要儿茶酚胺治疗的心源性休克,严重的急性呼吸困难,心脏复苏或者机械呼吸支持治疗。在德国5个临床研究中心中,共有23例患者接受了eTAVI治疗,118例患者接受了eBAV治疗。在eTAVI治疗组,术后的死亡率为8.7%,而eBAV治疗的为20.3%(p=0.19),30天后,eTAVI治疗组的心源性死亡率为23.8%,而eBAV组的为33%(p=0.40)。此外,急诊主动脉瓣球囊扩张术后接受主动脉瓣经导管置换术的术后即刻死亡率为9.4%,术后30天的心源性死亡率为15.6%。主要血管并发症(p=0.01)和卒中(p=0.01)在eTAVI组中发生风险更高。

本多中心临床研究结果显示,对于急性严重的主动脉狭窄失代偿患者,急诊主动脉瓣经导管置换术和急诊主动脉瓣球囊扩张术的术后即刻和术后30天的死亡率均较高,急诊主动脉瓣球囊扩张术后联合主动脉瓣经导管置换术治疗的死亡率比预期的更高。

原始出处:

本文系梅斯医学(MedSci)原创编译整理,转载需授权!

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1315157, encodeId=7b2e131515e89, content=<a href='/topic/show?id=c115231e9dc' target=_blank style='color:#2F92EE;'>#主动脉狭窄#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23179, encryptionId=c115231e9dc, topicName=主动脉狭窄)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2f8f432, createdName=longerg, createdTime=Sat Dec 30 06:49:00 CST 2017, time=2017-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356620, encodeId=d3a81356620df, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Dec 30 06:49:00 CST 2017, time=2017-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415256, encodeId=e53b14152562b, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Sat Dec 30 06:49:00 CST 2017, time=2017-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1496890, encodeId=c346149689084, content=<a href='/topic/show?id=217b33259df' target=_blank style='color:#2F92EE;'>#动脉狭窄#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33259, encryptionId=217b33259df, topicName=动脉狭窄)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b4ae9287436, createdName=piaojinhua, createdTime=Sat Dec 30 06:49:00 CST 2017, time=2017-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562778, encodeId=c4551562e7818, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Sat Dec 30 06:49:00 CST 2017, time=2017-12-30, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1315157, encodeId=7b2e131515e89, content=<a href='/topic/show?id=c115231e9dc' target=_blank style='color:#2F92EE;'>#主动脉狭窄#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23179, encryptionId=c115231e9dc, topicName=主动脉狭窄)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2f8f432, createdName=longerg, createdTime=Sat Dec 30 06:49:00 CST 2017, time=2017-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356620, encodeId=d3a81356620df, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Dec 30 06:49:00 CST 2017, time=2017-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415256, encodeId=e53b14152562b, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Sat Dec 30 06:49:00 CST 2017, time=2017-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1496890, encodeId=c346149689084, content=<a href='/topic/show?id=217b33259df' target=_blank style='color:#2F92EE;'>#动脉狭窄#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33259, encryptionId=217b33259df, topicName=动脉狭窄)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b4ae9287436, createdName=piaojinhua, createdTime=Sat Dec 30 06:49:00 CST 2017, time=2017-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562778, encodeId=c4551562e7818, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Sat Dec 30 06:49:00 CST 2017, time=2017-12-30, status=1, ipAttribution=)]
    2017-12-30 zhaojie88
  3. [GetPortalCommentsPageByObjectIdResponse(id=1315157, encodeId=7b2e131515e89, content=<a href='/topic/show?id=c115231e9dc' target=_blank style='color:#2F92EE;'>#主动脉狭窄#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23179, encryptionId=c115231e9dc, topicName=主动脉狭窄)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2f8f432, createdName=longerg, createdTime=Sat Dec 30 06:49:00 CST 2017, time=2017-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356620, encodeId=d3a81356620df, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Dec 30 06:49:00 CST 2017, time=2017-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415256, encodeId=e53b14152562b, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Sat Dec 30 06:49:00 CST 2017, time=2017-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1496890, encodeId=c346149689084, content=<a href='/topic/show?id=217b33259df' target=_blank style='color:#2F92EE;'>#动脉狭窄#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33259, encryptionId=217b33259df, topicName=动脉狭窄)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b4ae9287436, createdName=piaojinhua, createdTime=Sat Dec 30 06:49:00 CST 2017, time=2017-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562778, encodeId=c4551562e7818, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Sat Dec 30 06:49:00 CST 2017, time=2017-12-30, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1315157, encodeId=7b2e131515e89, content=<a href='/topic/show?id=c115231e9dc' target=_blank style='color:#2F92EE;'>#主动脉狭窄#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23179, encryptionId=c115231e9dc, topicName=主动脉狭窄)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2f8f432, createdName=longerg, createdTime=Sat Dec 30 06:49:00 CST 2017, time=2017-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356620, encodeId=d3a81356620df, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Dec 30 06:49:00 CST 2017, time=2017-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415256, encodeId=e53b14152562b, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Sat Dec 30 06:49:00 CST 2017, time=2017-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1496890, encodeId=c346149689084, content=<a href='/topic/show?id=217b33259df' target=_blank style='color:#2F92EE;'>#动脉狭窄#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33259, encryptionId=217b33259df, topicName=动脉狭窄)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b4ae9287436, createdName=piaojinhua, createdTime=Sat Dec 30 06:49:00 CST 2017, time=2017-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562778, encodeId=c4551562e7818, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Sat Dec 30 06:49:00 CST 2017, time=2017-12-30, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1315157, encodeId=7b2e131515e89, content=<a href='/topic/show?id=c115231e9dc' target=_blank style='color:#2F92EE;'>#主动脉狭窄#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23179, encryptionId=c115231e9dc, topicName=主动脉狭窄)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2f8f432, createdName=longerg, createdTime=Sat Dec 30 06:49:00 CST 2017, time=2017-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356620, encodeId=d3a81356620df, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sat Dec 30 06:49:00 CST 2017, time=2017-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415256, encodeId=e53b14152562b, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Sat Dec 30 06:49:00 CST 2017, time=2017-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1496890, encodeId=c346149689084, content=<a href='/topic/show?id=217b33259df' target=_blank style='color:#2F92EE;'>#动脉狭窄#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33259, encryptionId=217b33259df, topicName=动脉狭窄)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b4ae9287436, createdName=piaojinhua, createdTime=Sat Dec 30 06:49:00 CST 2017, time=2017-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562778, encodeId=c4551562e7818, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Sat Dec 30 06:49:00 CST 2017, time=2017-12-30, status=1, ipAttribution=)]
    2017-12-30 slcumt

相关资讯

JACC:肿瘤治疗的心血管并发症:诊断、预防和管理的更佳实践

2017年11月,美国科学家在《J Am Coll Cardiol》发表综述,介绍了肿瘤治疗的心血管并发症:诊断、预防和管理的最佳实践。

Lancet Diabetes Endo:吡格列酮的心血管风险如何?

2017年发表于《Lancet Diabetes Endocrinol》上的一项随机、多中心试验,考察了吡格列酮vs磺脲类药物对二甲双胍未充分控制血糖的2型糖尿病患者心血管事件发生率的影响。

Lancet Diabetes Endo:阿卡波糖对冠心病合并糖耐量受损患者心血管和糖尿病结局的影响

2017年发表于《Lancet Diabetes Endocrinol》上的一项随机、双盲、安慰剂对照试验,考察了阿卡波糖对冠心病合并糖耐量受损患者心血管和糖尿病结局的影响。

Heart:静息心率不仅与遗传相关,还与你的寿命相关!

静息心率(RHR)可能有遗传倾向,且与寿命有关。本研究的目的旨在评估RHR在中年双胎中的遗传倾向以及其与死亡率的相关性。本研究共纳入了4282个无心血管疾病的双胎,其中1233对为成对双胎,1816对双胎中仅一人参与了本研究,平均年龄为61.7 (SD 11.1)岁,在平均16.3年的随访时间中,有1334个双胎(31.2%)出现死亡,静息心率通过触诊桡动脉搏动获得。分析结果显示,静息心率的遗传率

Heart:心脏磁共振对Ebstein畸形患者预后的预测价值研究

患有Ebstein三尖瓣畸形的患者的快速型心律失常、充血性心衰和心源性猝死的风险会更高。本研究的目的旨在评估心脏磁共振(CMR)技术在预测这些不良心脏事件上的价值。本研究纳入了79例接受了CMR检查的Ebstein三尖瓣畸形的成年患者(平均年龄为37±15岁),平均随访时间为3.4年(0.4-10.9年),对其主要心血管不良事件MACEs(持续性室性心动过速、心衰住院率、心脏移植或死亡)和房性快速

中国心血管医学博物馆隆重开馆

12月27日,中国心血管医学博物馆正式开馆。