Patient Risk-Benefit Preferences for Transcatheter Versus Surgical Mitral Valve Repair.
Patient Risk-Benefit Preferences for Transcatheter Versus Surgical Mitral Valve Repair.
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经导管与二尖瓣手术修复的患者风险效益偏好。
DOI：
10.1161/jaha.123.032807
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发表时间：
2024
影响因子：
5.4
通讯作者：
Reed,ShelbyD
中科院分区：
文献类型：
--
作者：
Hung,Anna;Yang,Jui-Chen;Wallace,Matthew;Zwischenberger,BrittanyA;Vemulapalli,Sreekanth;Mentz,RobertJ;Thoma,Elizabeth;Goates,Scott;Lewis,John;Strong,Susan;Reed,ShelbyD
经导管边缘对边缘修补术(TEER)治疗二尖瓣返流比手术创伤小，但具有更高的5年死亡率和再干预风险，并导致较小的物理功能改善。该研究的目的是量化患者对与TEER和手术相关的风险-收益权衡的偏好。方法和结果对二尖瓣反流患者进行了离散选择实验调查。这些因素包括手术类型、30天的死亡风险、5年死亡风险和5 年的身体功能、未来5 年的住院次数和未来5 年的额外手术风险。采用混合Logit回归模型估计偏好权重。101个人完成了这项调查：63%是女性，平均年龄为74 岁。平均而言，受访者更喜欢TEER而不是手术。为了接受侵入性较小的手术(即TEER)，受访者将接受超过10%的再干预风险高达13.3%(95%CI，8.7%-18.5%)，超过基线1的住院次数增加4.6(95%CI，3.1-6.2)，超过基线20%的5年死亡风险增加10.7%(95%CI，6.5%-14.5%)，或者身体功能更有限，相当于纽约心脏协会分级(0.7[95%CI，4-1.1])。结论患者总体上更喜欢 手术。当所有其他因素保持不变时，平均而言，患者需要在5 年内将功能从纽约心脏协会III级改善到I级，以便患者更喜欢手术而不是TEER。
BackgroundTranscatheter edge‐to‐edge repair (TEER) of mitral regurgitation is less invasive than surgery but has greater 5‐year mortality and reintervention risks, and leads to smaller improvements in physical functioning. The study objective was to quantify patient preferences for risk–benefit trade‐offs associated with TEER and surgery.Methods and ResultsA discrete choice experiment survey was administered to patients with mitral regurgitation. Attributes included procedure type; 30‐day mortality risk; 5‐year mortality risk and physical functioning for 5 years; number of hospitalizations in the next 5 years; and risk of additional surgery in the next 5 years. A mixed‐logit regression model was fit to estimate preference weights. Two hundred one individuals completed the survey: 63% were female and mean age was 74 years. On average, respondents preferred TEER over surgery. To undergo a less invasive procedure (ie, TEER), respondents would accept up to a 13.3% (95% CI, 8.7%–18.5%) increase in reintervention risk above a baseline of 10%, 4.6 (95% CI, 3.1–6.2) more hospitalizations above a baseline of 1, a 10.7% (95% CI, 6.5%–14.5%) increase in 5‐year mortality risk above a baseline of 20%, or more limited physical functioning representing nearly 1 New York Heart Association class (0.7 [95% CI, 0.4–1.1]) over 5 years.ConclusionsPatients in general preferred TEER over surgery. When holding constant all other factors, a functional improvement from New York Heart Association class III to class I maintained over 5 years would be needed, on average, for patients to prefer surgery over TEER.
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影响因子：
4.6
作者：
GROSSI, EA;GALLOWAY, AC;COLVIN, SB
通讯作者：
COLVIN, SB
影响因子：
4.6
作者：
Bernal, JM;Gutiérrez-Morlote, J;Revuelta, JM
通讯作者：
Revuelta, JM
使用可生物降解的瓣环成形环修复急性心内膜炎瓣膜的中期结果。
DOI：
10.1016/j.athoracsur.2010.01.041
发表时间：
2010
期刊：
The Annals of thoracic surgery
影响因子：
--
作者：
E. Pektok;J. Sierra;M. Cikirikcioglu;H. Müller;P. Myers;A. Kalangos
通讯作者：
A. Kalangos
使用新型瓣环成形环修复儿科二尖瓣：Kalangos-Bioring®
影响因子：
0.7
作者：
M. Cikirikcioglu;E. Pektok;P. Myers;J. Christenson;A. Kalangos
通讯作者：
A. Kalangos
影响因子：
6
作者：
Dagum, P;Timek, T;Miller, DC
通讯作者：
Miller, DC