Heart:经导管二尖瓣介入治疗后的脑血管事件

2020-04-21 xiangting MedSci原创

经导管二尖瓣介入治疗与脑血管事件的发生率较低相关。

目前指南支持使用经导管二尖瓣介入治疗某些高危的二尖瓣疾病患者。与其他介入性心脏手术一样,人们对二尖瓣介入后的脑血管事件也存在担忧。这项系统评价和荟萃分析目的是确定(1)使用二尖瓣夹行经导管二尖瓣缘对缘修复(2)经导管二尖瓣置换术(TMVR)后脑血管事件的发生率。

对报道经导管二尖瓣缘对缘修复和TMVR手术后脑血管不良事件的研究进行了系统评价。主要终点是出现由二尖瓣学术研究联盟定义的脑血管事件。30天内或在指数住院期间发生的事件被定义为围手术期;否则被定义为非围手术期。这项研究是按照系统评价和Meta分析的首选报告项目设计的。使用随机效应模型汇总研究水平的汇总数据。每项研究的质量均由Hawker清单进行评估,这是一种系统评价不同范式研究的方法。

共纳入60项研究,包括28155例使用二尖瓣夹的缘对缘修复患者。围手术期卒中和非围手术期卒中的发生率分别为0.9%(95%CI 0.6-1.1)和2.4%(95%CI 1.6-3.2)。对于TMVR手术,分析了26项研究,共1910例患者。估算的围手术期卒中发生率为1%(95%CI为0.5-1.8),而非围手术期卒中为7%(95%CI为0.8-18.5)。

经导管二尖瓣介入治疗与脑血管事件的发生率较低相关。由于缺乏高质量的数据,这些并发症的确切机制仍不明确。

原始出处:

Gabriel Châteauneuf. Cerebrovascular events after transcatheter mitral valve interventions: a systematic review and meta-analysis. Heart. 17 April 2020.

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    2020-04-23 zhaojie88
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    2020-04-23 wwzzly
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    2020-04-23 lsj631
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    2020-04-23 slcumt

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