症状のない重度のミトラル吐における警戒待ちの結果
Raphael Rosenhek1, Florian Rader, Ursula Klaar
1Department of Cardiology, Medical University of Vienna, Vienna, Austria. raphael.rosenhek@meduniwien.ac.at
Circulation
|May 3, 2006
まとめ
警戒的な待機戦略は,無症状の重度のミトラル反発の管理に安全です. 患者は,症状または手術のための特定の基準が満たされるまでモニタリングされ,良い結果を保証することができます.
科学分野:
- 心臓病学 心臓病学
- 心臓外科手術について
- クリニカル・メディシン 臨床医学
背景:
- 症状のない重度のミトラル反発の管理は,論争の的です.
- 警戒待機戦略は,症状または特定の基準が満たされるまでモニタリングを伴う.
研究 の 目的:
- 重度の退行性ミトラル吐症に対する注意深い待機戦略の結果を評価する.
- 手術基準が満たされるまで,無症状患者のモニタリングの安全性と有効性を決定します.
主な方法:
- 重度の退行性ミトラル吐症の無症状患者132人の見通し追跡調査.
- 連続した臨床検査と心声検査.
- 症状,左心室 (LV) 拡張/機能障害,肺高血圧,心房細動などの症状に基づく外科推薦.
主要な成果:
- 総生存期間は,生存期間の期待値と同等であった.
- 38人の患者 (29%) は,平均62ヶ月の追跡期間で手術の基準を満たした.
- 手術の指示のない生存率は8年後に55+/-6%でした.
- 手術後の死亡率は認められず,手術後の良好なアウトカムも認められた.
結論:
- 症状のない重度の変性性ミトラル吐症の患者は安全にモニタリングすることができます.
- 症状または確立されたLV/肺高血圧の基準に達するまでフォローアップは実行可能である.
- この戦略は,最適な結果を出すために,患者さんの勤勉なモニタリングを必要とします.
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