重度の左心室機能不全による大動脈狭窄に対する大動脈弁置換術. 予測指標 予測指標
H M Connolly1, J K Oh, T A Orszulak
1Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Circulation
|May 20, 1997
まとめ
大動脈の狭窄のために大動脈弁の置換は,左心室内静脈機能不全の患者に実行可能である. 結果は受け入れられるもので,ほとんどの患者は症状と放出分子の改善を経験しているが,生存率は冠動脈疾患と関連している.
科学分野:
- 心臓病学 心臓病学
- 心臓外科手術について
背景:
- 左心室 (LV) 収縮機能不全による大動脈狭窄 (AS) は,弁置換のリスクを高めます.
- LVシストリック機能不全のAS患者のアウトカムに関するデータは限られている.
研究 の 目的:
- ASとLVのシストリック機能不全の患者における大動脈弁置換の結果を評価する.
主な方法:
- LVシストリック機能障害 (エジェクション分数 ≤35%) を有する154人の患者が,1985年から1992年の間にASのために大動脈弁置換手術を受けた.
- 冠動脈バイパス移植は患者の51%で行われました.
- フォローアップデータは,死亡率,生存率,エジェクション分数の変化を分析した.
主要な成果:
- 術後の死亡率は9%でした.
- 冠動脈疾患と手術前の心電量減少は,生存率の低下の有意な予測要因でした.
- 88%の患者は症状が改善した (NYHAクラスIII/IVの術前と術後の7%).
- 生存者の76%が,手術後のエジェクション分数の改善を示した.
結論:
- ASのための大動脈弁置換は,LV機能不全の患者に受け入れられます.
- 結果は冠動脈疾患と平均大動脈梯度によって影響を受けます.
- 長期的な生存率は冠動脈疾患と心臓出力に関連しています.
- ほとんどの患者は,症状とエジェクション分数の有意な改善を経験します.
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