Pu J Z, Wu W H, Ke Y T, Huang L J, Ma X H, Zhang C
Interventional Department, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing 100029, China.
Echocardiography Department, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing 100029, China.
Zhonghua Yi Xue Za Zhi. 2021 Apr 27;101(16):1160-1164. doi: 10.3760/cma.j.cn112137-20200901-02519.
To assess the immediate and mid-term outcomes and hospital costs of patients who underwent trans-catheter closure (TC) or surgical closure (SC) of perivalvular leakage (PVL). Patients who underwent treatment of TC and SC of PVL in our center between January 2016 and December 2019 were enrolled. Baseline characteristics, procedure success, in-hospital and mid-term outcomes and hospital costs were compared. A total of 141 patients were enrolled (TC, =65 and SC, =76). The patients in TC group were elder ((56.8±12.8) years vs (50.1±12.8) years, =-3.124, =0.002). Technical success was significant higher in the SC group (83.1% vs 98.7%, χ²=10.960, <0.001). And the residual PVLs were less in SC group (33.3% vs 13.3%, χ²=-2.525, =0.012). One patient in SC group had procedure-related death. Procedure room time ((93±38) min vs (395±132) min, =19.065, <0.001), intensive care unit time (0 h vs 28 (21, 74)h, =-10.738, <0.001), length of stay from hospitalization to discharge (7 (4, 10) days vs 21 (15, 25) days, =-8.075, <0.001) and costs (¥46 073 (36 837, 52 448) vs ¥130 798 (104 048, 186 188), =-10.059, <0.001) were significantly less in TC group. After risk adjustment, there was no significant difference in 30 days survival between TC group and SC group. At a median follow-up of 21 months, there was a trend towards reduced all-cause death following TC versus SC ( = 0.054, 95%: 0.07 to 0.445, = 0.007). SC for PVL is associated with higher technical rates and less residual shunt compared with TC approach. But, the shorter length of stay and lower resources use with TC group significantly reduce hospital costs. In addition, TC achieve a better mid-term results in survival.
评估接受经导管封堵（TC）或外科手术封堵（SC）治疗瓣周漏（PVL）患者的近期和中期结局及住院费用。纳入2016年1月至2019年12月在本中心接受PVL的TC和SC治疗的患者。比较基线特征、手术成功率、住院及中期结局和住院费用。共纳入141例患者（TC组65例，SC组76例）。TC组患者年龄较大（（56.8±12.8）岁 vs （50.1±12.8）岁，t=-3.124，P=0.002）。SC组的技术成功率显著更高（83.1% vs 98.7%，χ²=10.960，P<0.001）。且SC组的残余PVL更少（33.3% vs 13.3%，χ²=-2.525，P=0.012）。SC组有1例患者发生手术相关死亡。TC组的手术间时间（（93±38）分钟 vs （395±132）分钟，t=19.065，P<0.001）、重症监护病房时间（0小时 vs 28（21，74）小时，t=-10.738，P<0.001）、住院至出院的住院时间（7（4，10）天 vs 21（15，25）天，t=-8.075，P<0.001）和费用（46 073（36 837，52 448）元 vs 130 798（104 048，186 188）元，t=-10.059，P<0.001）均显著少于SC组。风险调整后，TC组和SC组30天生存率无显著差异。在中位随访21个月时，与SC组相比，TC组全因死亡有降低趋势（HR = 0.054，95%CI：0.07至0.445，P=0.007）。与TC方法相比，PVL的SC技术成功率更高且残余分流更少。但是，TC组较短的住院时间和较低的资源使用显著降低了住院费用。此外，TC在生存方面取得了更好的中期结果。
Zotero 插件