LunarShadow
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Дата: Воскресенье, 01.04.2018, 14:54 | Сообщение # 1 |
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Заглянувший
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Бабушке 78 лет. Стеноз аортального клапана. Врачи предлагают замену аортального клапана малоинвазивным способом. Какие риски? И какова вероятность летального исхода?
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Алексей_Денисов
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Дата: Воскресенье, 01.04.2018, 18:19 | Сообщение # 2 |
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Виртуальная Сущность
Группа: Администратор
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Int J Cardiol. 2014 Sep;176(1):32-9. doi: 10.1016/j.ijcard.2014.06.017. Epub 2014 Jun 27. Increased mortality after transcatheter aortic valve implantation (TAVI) in patients with severe aortic stenosis and low ejection fraction: a meta-analysis of 6898 patients. Sannino A1, Gargiulo G1, Schiattarella GG1, Brevetti L1, Perrino C1, Stabile E1, Losi MA1, Toscano E1, Giugliano G1, Scudiero F1, Chiacchio E1, Trimarco B1, Esposito G2. Author information Abstract BACKGROUND: There is conflicting evidence regarding the safety and efficacy of transcatheter aortic valve implantation (TAVI) procedures in patients with severe aortic stenosis and low left ventricular ejection fraction (EF). The primary aim of this study was to determine the impact of TAVI on short- and long-term mortality in patients with low EF (EF <50%); the secondary aim was to analyze the impact of TAVI procedure on EF recovery in the same setting of patients.
METHODS AND RESULTS: Twenty-six studies enrolling 6898 patients with severe aortic stenosis undergoing TAVI procedure were included in the meta-analysis and analyzed for 30-day, 6-month and 1-year all-cause and cardiovascular mortality; a further meta-analysis was also performed in patients with low EF to assess EF changes post TAVI. In low EF patients, both all-cause and cardiovascular short- and long-term mortality were significantly higher when compared to patients with normal EF (30-day-all-cause mortality: 0.13; 95% confidence interval [CI]: 0.01 to 0.25, I(2)=49.65, Q=21.85; 1-year-all-cause mortality: 0.25; 95% [CI]: 0.16 to 0.34, I(2)=25.57, Q=16.12; 30-day-cardiovascular mortality: 0.03; 95% [CI]: -0.31 to 0.36, I(2)=66.84, Q=6.03; 1-year-cardiovascular mortality: 0.29; 95% [CI]: 0.12 to 0.45, I(2)=0.00, Q=1.88). Nevertheless, in low EF patients TAVI was associated with a significant recovery of EF, which started at discharge and proceeded up to 1-year-follow-up.
CONCLUSIONS: Patients with low EF severe aortic stenosis have higher mortality following TAVI compared to normal EF patients, despite a significant and sustained improvement in EF. вот еще на тему https://www.ncbi.nlm.nih.gov/pubmed/24610508
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