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经导管主动脉瓣植入术后血管并发症的真实世界发生率。

Prevalence of Posttranscatheter Aortic Valve Implantation Vascular Complications in Real Life.

机构信息

Department of Cardiology, Institute CARDIOMET, University Hospital of Toulouse, Toulouse, France.

Faculty of Medicine, Holy Spirit University of Kaslik, Kaslik, Jounieh, Lebanon.

出版信息

J Interv Cardiol. 2021 Oct 12;2021:5563486. doi: 10.1155/2021/5563486. eCollection 2021.

Abstract

BACKGROUND

Vascular complications (VCs) are commonly observed after transfemoral transcatheter aortic valve implantation (TAVI) procedures. Closure devices for the access site were developed to reduce their incidence. We aim to evaluate the prevalence, predictors, and outcomes of the occurrence of post-TAVI VCs.

MATERIALS AND METHODS

A retrospective study was conducted on 1336 consecutive patients who underwent TAVI at the University Hospital of Toulouse, France, between January 2016 and March 2020. All included procedures were performed through the common femoral artery, and ProGlide was the used closure device. The studied population was divided into two groups depending on the occurrence of VCs defined according to Valve Academic Research Consortium-2 criteria.

RESULTS

The mean age of the studied population was 84.4 ± 6.9, and 48% were male. 90% of TAVI interventions were performed through the right femoral artery. The prevalence of VCs was 18.8%, and 3.7% were major. Prolonged procedure duration was an independent predictor of VCs. Using the right access site and smaller introducer size (14 Fr) were preventive factors. No significant difference in mortality rate was detected between the two groups.

CONCLUSION

This study showed a low prevalence for post-TAVI VCs, especially for the major type. An increase in bleeding events and prolonged cardiac care unit stay were the common adverse outcomes.

摘要

背景

经股动脉经导管主动脉瓣置换术(TAVI)后常发生血管并发症(VCs)。为了降低其发生率,开发了用于血管入路的闭合装置。我们旨在评估 TAVI 后 VCs 的发生频率、预测因素和结局。

材料和方法

对 2016 年 1 月至 2020 年 3 月期间在法国图卢兹大学医院接受 TAVI 的 1336 例连续患者进行了回顾性研究。所有纳入的手术均通过股总动脉进行,ProGlide 是使用的闭合装置。根据 Valve Academic Research Consortium-2 标准,根据 VCs 的发生情况将研究人群分为两组。

结果

研究人群的平均年龄为 84.4±6.9 岁,48%为男性。90%的 TAVI 干预是通过右侧股动脉进行的。VCs 的患病率为 18.8%,其中 3.7%为主要类型。手术时间延长是 VCs 的独立预测因素。使用右侧入路和较小的引入器尺寸(14Fr)是预防因素。两组间死亡率无显著差异。

结论

本研究显示 TAVI 后 VCs 的发生率较低,特别是主要类型。出血事件增加和心脏监护病房停留时间延长是常见的不良结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a08/8526196/d3a0b712ece0/JITC2021-5563486.001.jpg

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