经导管主动脉瓣置换术后永久起搏器植入的基于影像学的预测指标。
Imaging-based predictors of permanent pacemaker implantation after transcatheter aortic valve replacement.
作者信息
Routh Jared M, Joseph Lee, Marthaler Brodie R, Bhave Prashant D
机构信息
University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
Wake Forest University Health Sciences Center, Winston-Salem, NC, USA.
出版信息
Pacing Clin Electrophysiol. 2018 Jan;41(1):81-86. doi: 10.1111/pace.13249. Epub 2017 Dec 28.
BACKGROUND
Cardiac conduction abnormalities requiring permanent pacemaker (PPM) implantation are major complications of transcatheter aortic valve replacement (TAVR). We aimed to investigate whether the relationship between prosthetic valve size and cardiac-gated computed tomography (CT)-based aortic root complex measurements can aid in recognizing patients at risk for PPM implantation post-TAVR.
METHODS
We included 83 of 114 consecutive patients who underwent TAVR with the Edwards Sapien valve (Edwards Lifesciences, Irving, CA, USA) at our institution. We excluded patients with preexisting PPM, patients who required conversion to an open surgical procedure, and patients without CT data. We assessed the significance of various potential predictors of PPM placement post-TAVR.
RESULTS
Following TAVR, eight patients (9.6%) required PPM. Prosthetic valve to sinus of Valsalva (SOV) index was significantly higher in those patients requiring a PPM post-TAVR (84.1 ± 9.3 vs 76.8 ± 7.1, P = 0.009).
CONCLUSIONS
The prosthetic valve size to diameter of SOV index was identified as a novel predictor of PPM implantation after TAVR.
背景
需要植入永久起搏器（PPM）的心脏传导异常是经导管主动脉瓣置换术（TAVR）的主要并发症。我们旨在研究人工瓣膜尺寸与基于心脏门控计算机断层扫描（CT）的主动脉根部复合体测量值之间的关系是否有助于识别TAVR术后有植入PPM风险的患者。
方法
我们纳入了在我们机构接受爱德华 Sapien 瓣膜（美国加利福尼亚州欧文市爱德华生命科学公司）TAVR 的 114 例连续患者中的 83 例。我们排除了已有 PPM 的患者、需要转为开放手术的患者以及没有 CT 数据的患者。我们评估了 TAVR 后 PPM 植入各种潜在预测因素的意义。
结果
TAVR 后，8 例患者（9.6%）需要 PPM。TAVR 后需要 PPM 的患者中，人工瓣膜与主动脉瓣窦（SOV）指数显著更高（84.1±9.3 对 76.8±7.1，P = 0.009）。
结论
人工瓣膜尺寸与 SOV 直径指数被确定为 TAVR 后 PPM 植入的一个新的预测因素。
Zotero 插件