二尖瓣经导管边缘到边缘修复的程序简化:全超声心动图指导和结果

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Jianrui Ma , Peijian Wei , Fengwen Zhang , Junke Chang , Manchen Gao , Chuangshi Wang , Xiaofang Yan , Cheng Wang , Shouzheng Wang , Yongquan Xie , Fang Fang , Xiangbin Pan
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引用次数: 0

摘要

本小组率先尝试在超声心动图指导下简化二尖瓣经导管边缘到边缘修复(M-TEER)程序;然而,其安全性和有效性仍不清楚。本研究旨在比较超声心动图和透视联合指导下的传统手术的结果。方法回顾性分析2021年1月至2024年5月194例二尖瓣反流(MR)患者采用简化手术(超声指导组,113例)和传统手术(联合指导组,81例)的临床资料。采用倾向评分匹配法(PSM)进行敏感性分析。结果根据二尖瓣学术研究联盟的定义,回声指导组30天主要不良事件发生率、技术成功率、器械成功率和手术成功率分别为5.31%、97.3%、89.4%和88.5%,与联合指导组分别为8.64%、96.3%、85.2%和84.0% (p >;0.05)。两组患者的纽约心脏协会功能分级均有显著的MR降低和改善(p <;0.05)。1年无全因死亡率和全因死亡率及心力衰竭住院率在Echo指导组分别为94.5%(95%可信区间(CI), 89.8% - 99.4%)和90.1% (95% CI, 83.6% - 97.2%),与co指导组分别为92.1% (95% CI, 86.3% - 98.4%)和88.4% (95% CI, 81.6% - 95.9%) (p >;0.05)。psm -队列分析证实了这些发现。结论超声心动图引导下的简化M-TEER手术与超声心动图和透视联合引导下的传统手术效果相当。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Procedural simplification in mitral valve transcatheter edge-to-edge repair: full echocardiographic guidance and outcomes

Background

Our group pioneered attempts to simplify the mitral valve transcatheter edge-to-edge repair (M-TEER) procedure under full echocardiographic guidance; however, its safety and effectiveness remain unclear. This study aimed to compare its outcome with the traditional procedure under echocardiographic and fluoroscopic co-guidance.

Methods

From Jan 2021 to May 2024, 194 mitral regurgitation (MR) patients undergoing the simplified procedure (Echo guidance group, n = 113) and the traditional procedure (Co-guidance group, n = 81) were retrospectively reviewed. The propensity score matching (PSM) method was performed as a sensitivity analysis.

Results

As defined by Mitral Valve Academic Research Consortium, the 30-day major adverse events, technical success, device success, and procedural success in the Echo guidance group were 5.31 %, 97.3 %, 89.4 %, and 88.5 %, similar to 8.64 %, 96.3 %, 85.2 %, and 84.0 % in the Co-guidance group, respectively (p > 0.05). Significant MR reduction and improvements in New York Heart Association functional class were observed in both groups (p < 0.05). The 1-year freedom from all-cause mortality and a composite of all-cause mortality and heart failure hospitalization were 94.5 % (95 % confidence interval (CI), 89.8 %–99.4 %) and 90.1 % (95 % CI, 83.6 %–97.2 %) in the Echo guidance group, similar to 92.1 % (95 % CI, 86.3 %–98.4 %) and 88.4 % (95 % CI, 81.6 %–95.9 %) in the Co-guidance group, respectively (p > 0.05). PSM-cohort analysis confirmed these findings.

Conclusions

The simplified M-TEER procedure under full echocardiographic guidance showed comparable outcomes to the traditional procedure under echocardiographic and fluoroscopic co-guidance.
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来源期刊
IJC Heart and Vasculature
IJC Heart and Vasculature Medicine-Cardiology and Cardiovascular Medicine
CiteScore
4.90
自引率
10.30%
发文量
216
审稿时长
56 days
期刊介绍: IJC Heart & Vasculature is an online-only, open-access journal dedicated to publishing original articles and reviews (also Editorials and Letters to the Editor) which report on structural and functional cardiovascular pathology, with an emphasis on imaging and disease pathophysiology. Articles must be authentic, educational, clinically relevant, and original in their content and scientific approach. IJC Heart & Vasculature requires the highest standards of scientific integrity in order to promote reliable, reproducible and verifiable research findings. All authors are advised to consult the Principles of Ethical Publishing in the International Journal of Cardiology before submitting a manuscript. Submission of a manuscript to this journal gives the publisher the right to publish that paper if it is accepted. Manuscripts may be edited to improve clarity and expression.
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