急诊经导管主动脉瓣置换术应用于急性心力衰竭患者的临床疗效分析Clinical outcomes of emergency transcatheter aortic valve replacement in patients with acute heart failure
刘洪艳,龙艳丽,郭卉,徐承义,王波
摘要(Abstract):
目的 分析急诊经导管主动脉瓣置换术(TAVR)应用于急性心力衰竭患者的临床疗效及远期预后的影响因素。方法 回顾性研究2016年1月至2020年12月武汉亚洲心脏病医院行急诊TAVR的急性心力衰竭患者的临床资料,主要结局指标为在院全因死亡率,使用Kaplan-Meier曲线进行生存分析。结果 共计19例患者行急诊TAVR,平均年龄为(73.9±4.7)岁,男15例(78.9%)。住院期间死亡3例,其中2例为心肺复苏术后在体外膜肺氧合和主动脉内球囊反搏辅助下行TAVR,术后因多器官功能衰竭死亡,另外1例于TAVR术中出现心搏骤停抢救无效死亡。16例患者好转出院,进入随访,随访时间3~46个月,平均随访时间为19个月,随访期内死亡4例,死亡率为25.0%。根据术前是否合并二尖瓣中度以上的反流分为两组进行分析发现,两组生存率比较,差异有统计学意义(P=0.028),合并二尖瓣中度以上反流患者的生存率更低。结论 对于药物治疗无效、血流动力学不稳定的急性心力衰竭或心原性休克患者,急诊TAVR治疗具有一定可行性。同时合并二尖瓣反流的患者可能远期生存率更低。
关键词(KeyWords): 经导管主动脉瓣置换;急性心力衰竭;疗效;二尖瓣反流
基金项目(Foundation):
作者(Author): 刘洪艳,龙艳丽,郭卉,徐承义,王波
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