JACC:低危患者的TAVR

2019-05-22 xiangting MedSci原创

1年时,TAVR对低危的症状性严重主动脉瓣狭窄患者是安全的。

这项研究旨在评估低危患者经导管主动脉瓣置换术(TAVR)后1年的临床结局和经导管心脏瓣膜的血流动力学。

LRT试验(低危TAVR)的早期结果表明,TAVR对于外科瓣膜置换风险低的症状性严重主动脉瓣狭窄患者是安全的。

LRT试验是一项研究者发起的、前瞻性、多中心研究,是首个FDA批准的研究性器械豁免试验,用于评估TAVR在低危患者中的可行性。主要终点是30天的全因死亡率。次要终点包括1年时的临床结局和瓣膜血流动力学。

LRT试验招募了200名低危症状性严重AS患者,在11个中心接受TAVR。平均年龄为73.6岁,男性占61.5%。在30天时,死亡率为0,致残性卒中率为0,永久性起搏器植入率较低(5.0%)。随访1年,死亡率为3.0%,卒中率为2.1%,永久性起搏器植入率为7.3%。2名受试者(1.0%)因心内膜炎接受了外科再介入治疗。30天时14%的TAVR受试者有低衰减小叶增厚证据,这对1年时的瓣膜血流动力学没有影响,但卒中率在数值上升高(3.8%vs. 1.9%; p=0.53)。

1年时,TAVR对低危的症状性严重主动脉瓣狭窄患者是安全的。30天在少数TAVR患者中观察到的低衰减小叶增厚对长期瓣膜血流动力学没有影响。

原始出处:
Ron Waksman. TAVR in Low-Risk Patients 1-Year Results From the LRT Trial. JACC:Cardiovascular Interventions. 27 May 2019.

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    2019-07-24 hbwxf
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