结合主动脉和 mitra 门手术后长期结果的预测因素
1Cardiology Division, Department of Internal Medicine, University Hospital, Zurich, Switzerland. juraj.turina@dim.usz.ch
Circulation
|November 24, 1999
概括
手术前的心肌功能是关键的长期存活后结合主动脉和 mitra 门手术. 建议在心肌功能下降之前进行早期门置换,因为三手术会影响存活率.
科学领域:
- 心血管外科心血管外科
- 心脏门疾病 心脏门疾病
- 预测因素 预测因素
背景情况:
- 结合主动脉和 mitra 门手术后的长期预后尚不清楚.
- 影响结果的因素包括临床,血液动力学和手术程序.
研究的目的:
- 为了确定结合主动脉和 mitra 门手术后的长期生存预测因素.
- 评估手术前条件和手术干预对患者结果的影响.
主要方法:
- 在1975年至1989年期间,对170名接受了主动脉和中枢结合手术的患者进行了回顾性分析.
- 平均随访时间为10.6年,评估生存率和重复手术率.
- 单变量和多变量考克斯回归分析,以确定晚期存活的预测因素.
主要成果:
- 术后死亡率为4%;10年和20年生存率分别为61%和33%.
- 晚期生存的独立预测因素包括手术前的喷射分数,手术时的年龄和三手术.
- 额外的三门手术显著降低了晚期存活率.
结论:
- 手术前的心肌功能 (射出分数) 是长期存活的主要预测因素.
- 在心肌功能恶化之前,门更换至关重要,以改善结果.
- 结合主动脉和 mitra 膜疾病与额外的三角膜参与,对生存产生负面影响.
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