Eur Heart J:生物瓣膜失效后进行经导管主动脉瓣植入术的长期结局

2020-06-28 xiangting MedSci原创

失效瓣膜的大小会影响长期死亡率,而经导管瓣膜的类型会影响主动脉ViV术后是否需要再介入治疗。

由于生物瓣膜退化,主动脉瓣中瓣(ViV)手术越来越多。目前还没有关于主动脉ViV手术长期结局的数据。这项研究目的是对主动脉ViV术后的长期生存率和再介入进行大规模评估。

5年前共进行了1006例主动脉ViV手术[平均年龄77.7±9.7岁;男性占58.8%;STS-PROM评分中位数7.3%(4.2-12.0)]。患者使用美敦力自扩张瓣膜(CoreValve/Evolut,美敦力公司,美国明尼苏达州明尼阿波利斯)(n=523,52.0%)、爱德华兹球囊扩张瓣膜(EBEV,SAPIEN/SAPIEN XT/SAPIEN 3,爱德华兹生命科技,美国加州尔湾)(n=435,43.2%)和其他装置(n=48,4.8%)。与内径大的失效瓣膜(内径(ID)>20 mm)相比,第8年时内径小的失效瓣膜[ID≤20mm]患者的生存率较低(33.2%vs. 40.5%,P=0.01)。死亡率的独立相关因素包括内径小的失效瓣膜[危险比(HR)1.07(95%置信区间(CI)1.02–1.13)]、年龄[HR 1.21(95%CI 1.01–1.45)]和非经股动脉入路[HR 1.43(95%CI 1.11-1.84)。ViV后进行了40次再介入治疗。全因再干预的独立相关因素包括既往存在的严重瓣膜-患者不匹配[亚危险比(SHR)4.34(95%CI 1.31–14.39)]、装置位置不正确[SHR 3.75(95%CI 1.36–10.35)]、EBEV [ SHR 3.34(95%CI 1.26–8.85)和年龄[SHR 0.59(95%CI 0.44–0.78)]。

失效瓣膜的大小会影响长期死亡率,而经导管瓣膜的类型会影响主动脉ViV术后是否需要再介入治疗。

原始出处:

Sabine Bleiziffer. Long-term outcomes after transcatheter aortic valve implantation in failed bioprosthetic valves. Eur Heart J. 27 June 2020.

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    2020-07-03 gq1688888

    去了

    0

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channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23182, encryptionId=1dd6231822d, topicName=主动脉瓣)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc4b2500077, createdName=hittouch, createdTime=Tue Jun 30 10:19:53 CST 2020, time=2020-06-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357547, encodeId=c6b6135e5478d, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Tue Jun 30 10:19:53 CST 2020, time=2020-06-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1385120, encodeId=43281385120d1, content=<a href='/topic/show?id=99d99e03311' target=_blank style='color:#2F92EE;'>#长期结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97033, encryptionId=99d99e03311, topicName=长期结局)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2c31495, createdName=liuyg0228, createdTime=Tue Jun 30 10:19:53 CST 2020, time=2020-06-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1399098, encodeId=45b1139909833, content=<a href='/topic/show?id=49dd69399c2' target=_blank style='color:#2F92EE;'>#生物瓣膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69399, encryptionId=49dd69399c2, topicName=生物瓣膜)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/SicjCIAeTxGf3PibxsFPgEb3xtbibdR8KpjNN5V3XkiatR1BXv2o9YPVhSnazedCHtUUh9KJyUmqYnmS3fRlyJZ4Dw/132, createdBy=5c342186905, createdName=liao1620, createdTime=Tue Jun 30 10:19:53 CST 2020, time=2020-06-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415676, encodeId=741a14156e601, 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=Tue Jun 30 10:19:53 CST 2020, time=2020-06-30, status=1, ipAttribution=)]
    2020-06-30 zhaojie88
  8. 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  9. 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  10. 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