经皮穿刺治疗心脏瓣膜置换术后瓣周漏英文课件.ppt

2. Mortality post Edwards SOURCE registry Thomas et al, Circulation 2010 2. Mortality in SOURCE at 12 months 2. Mortality (30d) and learning curveVancouver Edwards experience n=250 Webb TCT 2009 2. Registry summary: 30 day mortality (n=279) (n=772) (n=833) (n=872) (n=248) (n=1038) (n=1483) Summary derived from multiple data EuroPCR 2010 3. Stroke Corevalve MRI study 73% clinically silent cerebral embolism Clinical symptoms of neurological deficits persisted in only 3.6% three months after TAVI. Ghanem et al, JACC 2010 3. Stroke MRI study vs 21 surgical patients 10 Corevalve, 22 Edwards New foci of restricted diffusion on MRI in 84% of TAVI vs 48% AVR (p=0.011) No clinical strokes in TAVI arm vs 1 (5% in surgical) At 3 month MRI- no residual signal change associated with the majority (80%) of the foci detected in the periprocedural period Kahlert et al, Circulation 2010 3. Summary: Stroke (n=279) (n=772) (n=833) (n=872) (n=248) (n=1038) (n=1483) Summary derived from multiple data EuroPCR 2010 4. Myocardial infarction No clear definition Incidence post TAVI not frequently mentioned in literature For coronary occlusion 0.9% in Corevalve post CE expanded evaluation 1.2% in French registry 5. Vascular complication- mortality REVIVE/REVIVAL Vascular complication No vascular complication 5. Vascular complications- SOURCE Thomas, PCR 09 5. Femoral vascular complications now not associated with increased death SOURCE registry, Thomas, EuroPCR 2010 5. Summary: Vascular complication (n=279) (n=772) (n=833) (n=872) (n=248) (n=1038) (n=1483) Summary derived from multiple data EuroPCR 2010 n/a 6. HemodynamicsPARTNER EU n=130 deBruyne TCT 2009 6. Valve area- Pooled Edwards Pooled REVIVE, REVIVAL, TRAVERCE, PARTNER EU 6. Hemodynamics Corevalve Schuler, TCT 2009 6. Hemodynamics prosthesis-patient mismatch Stented Stentless Clavel JACC 2009 Jilaihawi EHJ 2009 Tzikas AJC 2010 7. Functional status and Corevalve 7. Functional status- Edwards PARTNER EU deBruyne TCT 2009 8. Pacemaker