用自由式无支架生物假体替换大动脉:五年经验
K L Yun1, C F Sintek, A D Fletcher
1Department of Cardiac Surgery, Kaiser Permanente Medical Center, Los Angeles, CA 90027, USA. Kwok.L.Yun@KP.org
Circulation
|November 24, 1999
概括
自由式无支架的大动脉在老年患者中提供了出色的5年临床结果和血液动力学性能. 这种门置换手术显示出良好的生存率和显著减少左心室缩.
科学领域:
- 心血管外科心血管外科
- 生物材料在医学中的应用
- 医疗器械技术 医疗器械技术
背景情况:
- 无支架的大动脉门的目标是生理流动和减少跨膜梯度.
- 潜在的好处包括手术后改善左心室功能和重塑.
- 评估了Freestyle (Medtronic, Inc) 的临床和血液动力学结果.
研究的目的:
- 为了前性地分析Freestyle无支架大动脉的5年临床结果.
- 通过串行心声回声学来评估自由式门的血液动力学性能.
主要方法:
- 对95名老年患者 (平均年龄75岁) 的前性研究,这些患者接受了 Freestyle 假肢的大动脉置换.
- 心声扫描在手术前,出院时,以及定期间隔长达5年的时间进行.
- 对临床结果的分析,包括死亡率,重新手术率和门相关的发病率.
主要成果:
- 3%的30天手术死亡率和80%的5年精算生存率.
- 在5年内,有94%的无心脏死亡率和79%的无门相关发病/死亡率.
- 显著减少了跨膜梯度和左心室质量指数,有效孔径面积增加.
结论:
- 自由式无支架门可以安全地植入老年人体内.
- 观察到优秀的中期临床和血液动力学结果.
- 卓越的血液动力学包括降低梯度,改善孔径面积,以及左心室缩的回归.
相关概念视频
Mitral Valve Prolapse I: Introduction
IntroductionThe mitral valve, one of the heart's four valves, regulates blood flow. These valves have flaps that open and close to direct blood properly through the heart and body. During each heartbeat, the flaps open for blood to pass through and seal shut to prevent backflow. Specifically, the mitral valve opens to allow blood flow from the heart's upper left chamber to the lower left chamber. It then closes securely as the lower left chamber contracts to pump blood to the body, preventing...
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 Stenosis I: Introduction
Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
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...
Aortic Regurgitation III: Medical Management
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...


