To explore the risk assessment of adverse events on transcatheter aortic valve replacement
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摘要: 目的:探讨经导管主动脉瓣置换术(TAVR)治疗的不良事件风险评估指标。方法:选取2017年5月-2019年5月在我院行TAVR治疗后发生不良事件或死亡的患者共9例,作为A组,选取同期行TAVR治疗后未发生不良事件且仍存活的患者共22例,作为B组。收集并比较2组患者的年龄、病程、性别、病情、合并症、NYHA分级、心脏超声指标等资料,分析不良事件的相关因素以确定风险评估指标。结果:2组患者的主动脉瓣跨瓣压差、合并重度二尖瓣反流、左心功能不全比例、术前心房颤动比例、左房容积和左室后壁厚度比较差异均有统计学意义(P＜0.05);影响术后患者不良事件的相关因素包括术前合并重度二尖瓣反流、左心功能不全和心房颤动、高主动脉瓣跨瓣压差、高左房容积和高左室后壁厚度(P＜0.05)。结论:临床中术前、术后注意诊断并综合评估患者的心脏超声指标和合并症等资料,可降低患者行TAVR后不良事件发生的风险性。
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关键词:
- 经导管主动脉瓣置换术 /
- 不良事件 /
- 主动脉瓣跨瓣压差 /
- 风险评估
Abstract: Objective:To explore the risk assessment indicators of adverse events on transcatheter aortic valve replacement(TAVR).Method:From May 2017 to May 2019,9 patients with adverse events or death after TAVR in our hospital were selected as group A.22 patients who survived without adverse events after TAVR in the same period were selected as group B.The age,disease course,sex,condition,complications,NYHA classification,and cardiac ultrasound indexes were collected and compared between two groups.The related factors of adverse events were analyzed to determine risk assessment indicators.Result:There were significant differences on aortic valve pressure gradient,severe mitral regurgitation ratio,left ventricular insufficiency ratio,preoperative atrial fibrillation ratio,LAV and LVPW between two groups(P＜0.05).The related factors affecting adverse events included preoperative severe mitral regurgitation,left ventricular insufficiency,atrial fibrillation and high aortic valve pressure gradient,high LAV and high LVPW(P＜0.05).Conclusion:Preoperative and post-operative diagnosis and evaluation of echocardiographic parameters and complication can reduce the risk of adverse events after TAVR. -
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