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JAHA:商业引入经导管二尖瓣修复术对二尖瓣外科手术的影响

2020-04-06 xiangting MedSci原创

商业引入TMVr与心脏手术的发展相关,并不会取消其他疗法,并且对所有接受治疗的二尖瓣返流患者都有良好的临床效果。

目前使用MitraClip行经导管二尖瓣修复(TMVr)对心脏外科手术的影响尚不确定。这项研究目的是探讨商业引入TMVr对综合二尖瓣项目的影响。

研究评估了6年内在作者机构接受经导管或二尖瓣外科手术的875例患者(69±14岁;男性占58%)。主要结局是引入TMVr后外科手术量的变化以及外科和TMVr手术的短期死亡率。

接受MitraClip、单纯二尖瓣修复和任意二尖瓣手术的患者数量分别为249、292和626例。与外科手术相比,使用MitraClip的患者年龄更大(82±8岁vs 64±12岁;P<0.001),且发病率更高。引入MitraClip之后,外科手术量稳步增加至单纯二尖瓣手术每年10(95%CI,3–7),而全部二尖瓣手术达到每年17(95%CI,13–20)。MitraClip和外科手术量以相同速率增加(P=0.42)。MitraClip的院内死亡率为3.2%,全部二尖瓣手术的院内死亡率为2.1%(P=0.33)。第30天时,经导管和外科手术的生存率(P=0.17)和无心衰再住院率(P=0.75)相似。

商业引入TMVr与心脏手术的发展相关,并不会取消其他疗法,并且对所有接受治疗的二尖瓣返流患者都有良好的临床效果。这些发现证明补充疗法在二尖瓣返流患者治疗中的潜在益处。

原始出处:

Hiroki Niikura. Impact of the Commercial Introduction of Transcatheter Mitral Valve Repair on Mitral Surgical Practice. JAHA. 04 April 2020.

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    2020-04-08 zhaohui6731
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    2020-04-08 wwzzly
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    2020-04-08 lsj631

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