经皮主动脉瓣置换术中应用自膨式瓣膜的嵴上嵴下重叠切面与 30 天传导障碍的关系。
Impact of Cusp-Overlap View for TAVR with Self-Expandable Valves on 30-Day Conduction Disturbances.
机构信息
Cardiology and Cardiovascular Surgery Institute (ICyCC), Favaloro Foundation University Hospital, Buenos Aires, Argentina.
MC Medicor, International Center for Cardiovascular Diseases, Izola, Slovenia.
出版信息
J Interv Cardiol. 2021 Apr 28;2021:9991528. doi: 10.1155/2021/9991528. eCollection 2021.
METHODS AND RESULTS
We retrospectively compared 257 consecutive patients undergoing TAVR with self-expandable valves using either CON ( = 101) or COVL ( = 156) in four intermediate/low volume centers. There were no significant differences in baseline characteristics between the groups. The 30-day incidence of new-onset LBBB (12.9% vs. 5.8%; =0.05) and PPMI rate (17.8% vs. 6.4%; =0.004) was significantly lower when using the COVL implantation view. There was no difference between the CON and COVL groups in 30-day incidence of death (4.9% vs. 2.6%), any stroke (0% vs. 0.6%), and the need for surgical aortic valve replacement (0% for both groups).
CONCLUSION
Using the COVL view for implantation, we achieved a significant reduction of the LBBB and PPMI rate after TAVR in comparison with the traditional CON view, without compromising the TAVR outcomes when using self-expandable prostheses.
方法与结果
我们回顾性比较了在四个中等/低容量中心使用自膨式瓣膜行经导管主动脉瓣置换术（TAVR）的 257 例连续患者，其中 CON 组（n=101）和 COVL 组（n=156）。两组患者的基线特征无显著差异。COVL 入路组新发左束支传导阻滞（LBBB）（12.9%比 5.8%；=0.05）和起搏器植入率（PPMI）（17.8%比 6.4%；=0.004）明显低于 CON 组。CON 组和 COVL 组 30 天死亡率（4.9%比 2.6%）、任何卒中发生率（0%比 0.6%）以及外科主动脉瓣置换术（SAVR）需求率（两组均为 0%）均无差异。
结论
与传统 CON 入路相比，COVL 入路可显著降低 TAVR 后新发 LBBB 和 PPMI 发生率，同时使用自膨式瓣膜并不影响 TAVR 结局。
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