Bajaj Anurag, Pancholy Samir, Sethi Arjinder, Rathor Parul
The Wright Center for Graduate Medical Education, Scranton, PA, USA; The Common Wealth Medical College, Scranton, PA, USA.
The Wright Center for Graduate Medical Education, Scranton, PA, USA; The Common Wealth Medical College, Scranton, PA, USA.
Heart Lung. 2017 Mar-Apr;46(2):92-99. doi: 10.1016/j.hrtlng.2016.12.003. Epub 2017 Jan 11.
We aimed to evaluate the safety and feasibility of PCI (percutaneous coronary intervention) for coronary artery disease (CAD) in patients undergoing transcatheter aortic valve replacement (TAVR) by performing a meta-analysis. A systemic search of the database was performed. Studies were included comparing TAVR versus TAVR with PCI for significant CAD in patients undergoing TAVR for severe aortic stenosis. The primary outcome was 30 day mortality and secondary outcomes were myocardial infarction, stroke, life threatening bleeding, major access site vascular complications and renal failure. There were no significant differences in 30 day and six months-one year mortality between TAVR and TAVR with PCI group. There were also no significant differences in myocardial infarction, stroke, and life threatening bleeding and major access site vascular complications between the two groups. PCI in addition to TAVR in patients with concomitant severe aortic stenosis and CAD is safe and feasible and does not increase procedural risk.
我们旨在通过进行一项荟萃分析，评估经导管主动脉瓣置换术（TAVR）患者中经皮冠状动脉介入治疗（PCI）用于冠状动脉疾病（CAD）的安全性和可行性。对数据库进行了系统检索。纳入的研究比较了TAVR与TAVR联合PCI治疗严重主动脉瓣狭窄且合并显著CAD的TAVR患者。主要结局为30天死亡率，次要结局为心肌梗死、中风、危及生命的出血、主要穿刺部位血管并发症和肾衰竭。TAVR组与TAVR联合PCI组在30天及6个月至1年死亡率方面无显著差异。两组在心肌梗死、中风、危及生命的出血和主要穿刺部位血管并发症方面也无显著差异。对于合并严重主动脉瓣狭窄和CAD的患者，TAVR联合PCI是安全可行的，且不会增加手术风险。
