带有或没有相关缺陷的先天性关节狭窄:一个不断发展的外科手术策略
1Department of Pediatric Cardiac Surgery, Marie-Lannelongue Hospital, Le Plessis-Robinson, France.
Circulation
|November 18, 2000
概括
单阶段修复对于先天性心肌狭窄 (CMS) 和相关缺陷更优越,比分阶段方法提供更好的存活率. 对这些复杂的先天性心脏病例来说,米特拉置换应该是最后的手段.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 生产性心脏手术 手术 生产心脏手术
- 膜心脏疾病 膜心脏疾病
背景情况:
- 先天性心肌狭窄症 (CMS) 带来了重大的外科手术挑战,特别是当与其他先天性心脏缺陷同时发生时.
- 对于CMS的最佳手术策略,特别是在复杂的病例中,仍然是正在进行的调查的主题.
研究的目的:
- 分析先天性额头狭窄症 (CMS) 和相关缺陷的外科手术策略的演变.
- 为了比较单阶段与分阶段修复方法的结果,在儿童患者中使用CMS.
主要方法:
- 在1980年至1999年期间,对72名儿童进行了先天性心脏缺陷手术,包括CMS手术的回顾性分析.
- 将患者分类为孤立的CMS或CMS与相关缺陷 (心室隔膜缺陷,左心室外流通道阻塞).
- 在单阶段和分阶段修复组之间比较早期和晚期死亡率,再手术率和长期存活率.
主要成果:
- 早期死亡率为12.5%,较高的比例与左心室外流通道阻塞和分阶段方法有关.
- 在孤立的CMS或单阶段修复组中没有死亡.
- 在15年后,整体存活率为69.6%,无需重新手术为70.8%,无需额头门置换为69%.
结论:
- 对于孤立的先天性心肌狭窄症 (CMS) 的手术产生了优秀的早期和长期结果.
- 一个单阶段的手术方法似乎优于CMS与相关心脏缺陷的分阶段方法.
- 在复杂的儿科先天性心脏病病例中,米特拉置换应保留为救援程序.
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