JACC:经导管肺动脉瓣置换术中使用Melody瓣膜进入小直径扩张性右室流出道导管

2018-03-22 xiangting MedSci原创

TPVR时使用Melody瓣膜进入可扩张的小直径导管是安全可行的,具有良好的早期和长期手术和血流动力学结局。

这项研究旨在评估导管直径≤16mm的经导管肺动脉瓣置换术(TPVR)的安全性、可行性和结局。

Melody瓣膜(美敦力,Minneapolis,明尼苏达州)被批准用于治疗植入时直径≥16毫米的功能障碍右室流出道(RVOT)导管。然而关于在较小的导管中使用此装置的数据很有限。

该研究回顾性评估了来自9个中心,植入时导管直径≤16mm的经皮TPVR患者,并报告手术特点和结局。

共纳入140名患者,其中117名患者(78%;中位年龄11岁,中位体重35kg)成功接受TPVR。原始导管直径中位数为15mm(范围:9至16mm),最窄导管直径的中位数为11 mm(范围:4至23 mm)。导管扩大到中位直径19 mm(比植入直径大29%),导管之间没有差异。植入后有显著的血流动力学改善,RVOT压力梯度残余峰值为7mmHg(p<0.001),无明显的肺反流。在中位随访2年期间,2年时和4年时分别有97%和89%无RVOT再次介入治疗,无死亡病例和5例心内膜炎(每患者年的发生率为2.0%)。

在此初步经验中,TPVR时使用Melody瓣膜进入可扩张的小直径导管是安全可行的,具有良好的早期和长期手术和血流动力学结局。

原始出处:

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    2018-05-14 yxch48
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    2018-09-24 lsj637
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objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Sat Mar 24 06:14:00 CST 2018, time=2018-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1510125, encodeId=67de151012562, content=<a href='/topic/show?id=e9bce8254ef' target=_blank style='color:#2F92EE;'>#经导管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78254, encryptionId=e9bce8254ef, topicName=经导管)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=93e010191378, createdName=lsj631, createdTime=Sat Mar 24 06:14:00 CST 2018, time=2018-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1539187, 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createdTime=Sat Mar 24 06:14:00 CST 2018, time=2018-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1583558, encodeId=a8e01583558d1, content=<a href='/topic/show?id=508d68e698c' target=_blank style='color:#2F92EE;'>#瓣膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68769, encryptionId=508d68e698c, topicName=瓣膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=58dc16986228, createdName=12498e5fm17(暂无昵称), createdTime=Sat Mar 24 06:14:00 CST 2018, time=2018-03-24, status=1, ipAttribution=)]
    2018-12-06 hbwxf
  5. 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createdTime=Sat Mar 24 06:14:00 CST 2018, time=2018-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1583558, encodeId=a8e01583558d1, content=<a href='/topic/show?id=508d68e698c' target=_blank style='color:#2F92EE;'>#瓣膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68769, encryptionId=508d68e698c, topicName=瓣膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=58dc16986228, createdName=12498e5fm17(暂无昵称), createdTime=Sat Mar 24 06:14:00 CST 2018, time=2018-03-24, status=1, ipAttribution=)]
  6. 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  7. 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createdTime=Sat Mar 24 06:14:00 CST 2018, time=2018-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1583558, encodeId=a8e01583558d1, content=<a href='/topic/show?id=508d68e698c' target=_blank style='color:#2F92EE;'>#瓣膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68769, encryptionId=508d68e698c, topicName=瓣膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=58dc16986228, createdName=12498e5fm17(暂无昵称), createdTime=Sat Mar 24 06:14:00 CST 2018, time=2018-03-24, status=1, ipAttribution=)]
    2018-03-24 lsj631
  8. 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  9. 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