単純なおよび複雑な退行性疾患のためのロボットミトラルバルブ修復: 中期臨床およびエコーカルディオグラフィク品質の成果
Rakesh M Suri1, Amit Taggarse2, Harold M Burkhart2
1From Divisions of Cardiovascular Surgery (R.M.S., A.T., H.M.B., R.C.D., J.A.D.), Anesthesiology (W.M.), Cardiovascular Diseases (R.A.N., H.I.M., M.E.-S.), and Biomedical Statistics and Informatics (Z.L.), Mayo Clinic, Rochester, MN. surir@ccf.org.
Circulation
|October 21, 2015
まとめ
重度の退行性ミトラル反発 (MR) に対するロボットミトラル弁修復は,中期的に優れた結果を示しています. この最小侵襲的アプローチは,疾患の複雑さに関係なく,高い生存率と低い再発率を提供し,従来の方法に価値ある代替手段を提供します.
科学分野:
- 心血管外科
- 侵襲性の少ない技術
- 心臓弁の修復
背景:
- 重度の一次性退行性ミトラル嘔吐 (MR) は,効果的な修復戦略を必要とします.
- 単純なケースでは持続的な結果が出ますが,最小侵襲的な修復による複雑なMRの中間結果はあまり理解されていません.
研究 の 目的:
- 重度の非血性退化性MRにおけるロボットによるミトラル弁修復の中間品質評価
- 単純と複合のミトラリゲルテーション修復症例の結果を比較する.
主な方法:
- 2008年から2015年まで重度の退行性MRのためにロボットでミトラル弁を修復した487人の患者の遡及的分析.
- 患者の分類は単純 (289) と複合 (198) 修復グループ.
- 生存率,機能的クラス,MR再発率,および中期フォローアップにおける再手術率の評価
主要な成果:
- 5年生存率は,単純な修復群と複雑な修復群の両方で99. 5%でした.
- 患者の97. 9%がニューヨーク心臓協会のI/ II機能クラスに達した.
- 5年間の中等から重度のMR再発の自由度は94. 6%であり,再手術の自由度は97. 7%であり,単純な症例と複雑な症例の有意な違いはなかった.
結論:
- 退行性MRIのロボット弁の修復は 中間期に優れた結果をもたらします
- 修復の複雑さに関係なく,高い生存率,稀な合併症,および低いMR再発が達成されます.
- これらの発見は,従来と皮膚経由のミトラ修復の 質の高い代替手段としてロボット修復を 支持しています.
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