5歳未満の子供におけるミトラル弁置換後の長期生存率:複数の機関を対象とした研究
C A Caldarone1, G Raghuveer, C B Hills
1Department of Surgery, University of Iowa College of Medicine, Iowa City, IA, USA. christopher-caldarone@uiowa.edu
Circulation
|September 25, 2001
まとめ
小児のミトラル弁置換術 (MVR) の結果は,これまで考えられていたよりも良好です. 早期の死亡率は,診断と弁のサイズによって予測可能であり,遅期の死亡率は低く,治療決定に役立ちます.
科学分野:
- ペディアトリック・カルディオロジー
- 心臓外科手術について
- バイオメディカルエンジニアリング
背景:
- 5歳未満の小児における義足のミトラル弁置換 (MVR) のアウトカムはよく定義されず,一般的に不良とみなされています.
- 本研究では,1982年から1999年にかけての小児心臓ケアコンソーシアムの経験について検討しています.
研究 の 目的:
- 5歳未満の小児における人工ミトラ弁置換 (MVR) の短期的および長期的結果を評価する.
- この患者集団における死亡率と再手術の予測要因を特定する.
主な方法:
- 5歳未満の139人の患者に実施された176件のミトラ弁置換術 (MVR) の遡及的レビュー.
- フォローアップ期間の中央値は6.2年,完了率は96%でした.
- 死の予測要因を特定するために,多変量分析を使用した.
主要な成果:
- 1,5,10年の生存率はそれぞれ79%,75%,74%でした.
- 合併症には,心臓閉塞 (16%),内臓炎 (6%),血栓症 (3%),脳卒中 (2%) が含まれていた.
- 早期死亡の予測要因には,完全な心房内腔管,ショーン症候群,および義肢弁のサイズと重量比の増加が含まれています.
結論:
- 小児用ミトラ弁置換術 (MVR) の後の早期死亡率は,診断と義肢のサイズと重量比によって予測できます.
- 遅い死亡率は低く,5年後に再手術の必要性がないのは81%です.
- これらの発見は,幼児におけるMVRと緩和策の間の治療決定を導くのに役立ちます.
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