リウマチ性ミトラ弁不全における再建手術の長期 (29年) の結果
S Chauvaud1, J F Fuzellier, A Berrebi
1Department of Cardiovascular Surgery, Hôpital Européen Georges Pompidou, Paris, France. sylvain.chauvaud@egp.ap-hop-paris.fr
Circulation
|September 25, 2001
まとめ
リウマチ性ミトラ弁不全の保守的な手術は,低病院死亡率と許容可能な再手術率を提供します. このアプローチは,患者における血栓塞栓性イベントのリスクが最小限に抑えられ,優れたアウトカムを示しています.
科学分野:
- 心血管外科手術についてです.
- リウマチ性心疾患とは
- ミトラルバルブの修理
背景:
- 退行性ミトラ弁不全の既定のアウトカムとは対照的に,リウマチ病の進行中の議論があります.
- この研究は,リウマチ性ミトラ弁不全の機能的アプローチを1つのセンターで焦点を当てています.
研究 の 目的:
- リウマチ性ミトラ弁不全の保守的な外科的手法の有効性と長期的な結果を評価する.
- 病院での死亡率,再手術率,およびリウマチ患者のミトラ弁修復後の血栓塞栓事件を評価する.
主な方法:
- リウマチ性ミトラ弁不全の951人の患者を分析し,再建手術を受けた (1970年-1994年).
- 機能分類 (タイプI,II,III) と特定のカーペンティアの技術が採用されました.
- 外科的介入には,義肢のリングの埋め込み,弦管の縮小,小葉の拡大,およびコンシューロトミーが含まれていました.
主要な成果:
- 病院での死亡率は2%でした. 平均追跡期間は12年でした.
- 精算学的生存率は,10年後に89%,20年後に82%でした.
- 再手術の必要性は10年後の82%と20年後の55%で,主な原因は進行性線維症でした.
結論:
- リウマチ性ミトラ弁不全のための保守的な手術は,低病院死亡率と関連しています.
- この研究は,許容可能な再手術率と,血栓塞栓性イベントに関する優れた結果を示しています.
- 長期的な結果は,心筋リウマチ性疾患における重建性ミトラ弁手術の生存可能性を示しています.
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