65歳以上の患者における皮膚経由のミトラバルボトミーの即時および長期的な結果
E M Tuzcu1, P C Block, B P Griffin
1Department of Medicine (Cardiac Unit), Massachusetts General Hospital, Harvard Medical School, Boston 02114.
Circulation
|March 1, 1992
まとめ
皮膚経由の風船ミトラルバルボトミー (PMV) は,ミトラル狭窄症の高齢患者にとって安全で効果的な結果を提供します. エコーカルディオグラフィーと光顕微鏡を用いた慎重な患者の選択は,成功の結果の鍵です.
科学分野:
- 心臓病学 心臓病学
- 介入性心臓病学 介入性心臓病学
- バルブ性心疾患 バルブ性心疾患とは
背景:
- 99人の高齢者 (≥65歳) の患者で,皮膚経由のバルーン・ミトラルバルボトミー (PMV) の結果を分析した.
- 81人の女性と18人の男性で,平均年齢は72歳.
- 患者はしばしば,ニューヨーク心臓協会 (NYHA) のクラスIII/IV,併発症,およびミトラル弁の化などの高度な症状を呈した.
研究 の 目的:
- 高齢者の患者におけるPMVの直接的および長期的なアウトカムを評価する.
- PMV後の成功と生存の予測要因を特定する.
- この特定の人口集団におけるPMVの安全性と有効性を確立するために.
主な方法:
- PMV.を受けた99人の患者の遡及的分析.
- 手術成功の評価は,ミトラ弁の領域,ミトラ弁の反吐,シャントによって定義されます.
- 成功と生存の予測要因を決定するための多変量分析.
- アクチュアリアル生存率とイベントフリー生存率を含む長期的な追跡.
主要な成果:
- 46人の患者 (46.5%) の処置が成功しました.
- 合併症には,手順による死亡 (3),心周タンポネード (5),および血栓塞栓症 (3) が含まれていた.
- 成功したPMVグループは,3年後の精算学的生存率 (79%対62%) と,MV置換なしの生存率 (71%対41%),およびイベントフリー生存率を大幅に改善しました.
- 低エコー・カルディオグラフィスコア,MVカルシフィケーションの欠如,低NYHAクラス,低圧はより良い結果を予測した.
結論:
- PMVは,選択された高齢の患者において,即時および長期的な良好な結果をもたらす安全な処置です.
- エコーカルディオグラフィの評価と化のための光学スクリーニングは,患者の選択に不可欠です.
- 最適化された患者選択は,高齢者のPMV後の改善された結果と生存率につながる可能性があります.
関連する概念動画
Mitral Valve Prolapse II: Assessment and Management
IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular tachycardia.
Mitral Valve Prolapse III: Nursing Management
The nursing management of Mitral Valve Prolapse, or MVP, centers around patient education, symptom monitoring, and lifestyle modifications.Patient Education on MVP Diagnosis and Heredity: Nurses should provide comprehensive education about MVP, a condition where the mitral valve does not close appropriately during heartbeats. This education often includes the condition's pathophysiology, symptoms, and potential complications, like arrhythmias or mitral regurgitation. Though not fully...
Mitral Regurgitation III: Medical Management
Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
Mitral Stenosis II: Clinical features and Diagnostic Tests
Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
Mitral Stenosis III: Medical Management
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
Mitral Stenosis IV: Nursing Management
A comprehensive nursing assessment is essential for patients with valvular heart disease, which involves any dysfunction of the heart valves that could impact blood flow and overall heart function.Subjective Data Collection:Chief Complaint and Present Illness: Start with the patient's primary concerns, focusing on the onset, duration, and progression of cardiac symptoms such as dyspnea, fatigue, chest pain, and palpitations.Past Medical History: Collect detailed information on any previous...


