■瓣周漏(PVL)是人工瓣膜置换的严重并发症。手术和经皮闭合技术均用于PVL闭合,但最优策略和比较结果是不确定的。本研究旨在通过分析渗漏严重程度的变化,比较经皮与外科PVL封堵术的疗效和安全性。功能状态,超声心动图参数,和临床结果。
■这项回顾性横断面单中心研究共纳入了72例患者,比较了2015年至2022年经皮(n=25)和手术(n=47)PVL封堵术。人口统计,病史,超声心动图,实验室数据,并发症,并从记录中提取死亡率数据.泄漏严重程度的变化,NYHA类,超声心动图参数,比较经皮组和手术组的临床结局。
■经皮和手术PVL封堵术都能显著降低渗漏严重程度,提高NYHA等级(均p<0.01),各组变化量无差异。经皮闭合后30天死亡率为4%,手术闭合后为6.4%(p=0.65)。90天,经皮死亡率为24%,手术死亡率为17%(p=0.48).经皮治疗组的住院时间和术后血红蛋白下降明显较低。两组之间的并发症发生率相似。超声心动图的变化也具有可比性。
■经皮和外科PVL封堵术在减少渗漏和改善症状方面具有相似的功效,早期结果没有显着差异。在心脏团队评估后,这两种选择对于PVL修复应被认为是可行的。
UNASSIGNED: Paravalvular leak (PVL) is a serious complication of prosthetic valve replacement. Both surgical and percutaneous closure techniques are used for PVL closure, but optimal strategies and comparative outcomes are uncertain. This study aimed to compare the efficacy and safety of percutaneous versus surgical PVL closure by analyzing changes in leak severity, functional status, echocardiographic parameters, and clinical outcomes.
UNASSIGNED: A total of 72 patients were included in this retrospective cross-sectional single-center study comparing percutaneous (n = 25) and surgical (n = 47) PVL closure from 2015 to 2022. Demographics, medical history, echocardiograms, laboratory data, complications, and mortality data were extracted from the records. Changes in leak severity, NYHA class, echocardiographic parameters, and clinical outcomes were compared between the percutaneous and surgical groups.
UNASSIGNED: Both percutaneous and surgical PVL closure significantly reduced leak severity and improved NYHA class (both p < 0.01), with no difference between the quantity of changes in each group. The 30-day mortality was 4% after percutaneous and 6.4% after surgical closure (p = 0.65). At 90 days, mortality was 24% percutaneous versus 17% surgical (p = 0.48). The length of stay in the hospital and post-procedural decrease in hemoglobin were considerably lower in the percutaneous group. The rate of complication rates was similar between the groups. Echocardiographic changes were also comparable.
UNASSIGNED: Percutaneous and surgical PVL closure had similar efficacy in reducing leaks and improving symptoms, with no significant difference in early outcomes. Both options should be considered viable for PVL repair after heart team evaluation.