在肺部自体移植更换大动脉门后,右心室功能
G S Carr-White1, M Kon, T W Koh
1Department of Academic Surgery, National Heart and Lung Institute, Royal Brompton Hospital, London, UK. g.carr-white@rbh.nthames.nhs.uk
Circulation
|November 24, 1999
概括
使用肺部自体移植或同体移植进行的大动脉置换会导致持续的右心室 (RV) 功能障碍. 这种RV纵向功能障碍在罗斯手术和同种植组中都是相似的,需要进一步调查.
科学领域:
- 心血管外科心血管外科
- 心脏生理学 心脏生理学
- 医疗成像医学成像
背景情况:
- 罗斯手术,涉及肺部自移植的使用,需要右心室 (RV) 流出通道切除和长时间的交叉.
- 有关这些程序对VR功能的影响存在担忧.
研究的目的:
- 评估动脉置换与肺自体移植相比同体移植对右心室 (RV) 功能的影响.
- 为了比较两个手术组之间的RV纵向功能和体积.
主要方法:
- 在手术前和后 (6个月) 进行了心声影像RV长轴测量 (缩,缩短和延长率).
- 在手术后6-35个月的患者中,MRI和心声回声学评估了RV体积 (终端透析,终端抽缩,中风体积).
- 预期随机试验设计,比较肺自移植和同移植组.
主要成果:
- 在手术后,所有患者都显示了与手术前相比,RV缩,缩短和延长率 (P<0.05) 降低.
- 在肺自移植和同移植组之间没有观察到VR纵向功能障碍的显著差异.
- 在两组中,RV的全球体积同样增加,而中风的体积在手术后保持不变.
结论:
- 用肺自移植或大动脉同移植进行大动脉置换会导致持续的RV纵向功能障碍.
- 在罗斯手术和大动脉同移植组之间,RV功能障碍的程度是可比的.
- 需要进一步的研究来了解这些RV变化的机制和长期后果.
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