长期 (29年) 在风湿性米特拉缺陷中重建性手术的结果
S Chauvaud1, J F Fuzellier, A Berrebi
1Department of Cardiovascular Surgery, Hôpital Européen Georges Pompidou, Paris, France. sylvain.chauvaud@egp.ap-hop-paris.fr
Circulation
|September 25, 2001
概括
对于类风湿性 mitra 膜缺陷的保守性手术提供了低的医院死亡率和可接受的重新手术率. 这种方法显示出优异的结果,患者患有血栓栓塞事件的风险最小.
科学领域:
- 心血管外科心血管外科
- 类风湿性心脏病 类风湿性心脏病
- 中心门维修 维修中心门
背景情况:
- 对于退行性 mitra 缺陷的已确定的结果与在风湿性疾病中正在进行的辩论形成鲜明对比.
- 这项研究侧重于一种功能性方法,在单一中心治疗类风湿性 mitra insufficiency.
研究的目的:
- 评估风湿性 mitra 膜缺陷的保守外科手术技术的疗效和长期结果.
- 评估风湿患者中中膜修复后的医院死亡率,重新手术率和血栓栓塞事件.
主要方法:
- 对951名患有风湿性 mitra 膜缺陷的患者进行了分析,这些患者接受了重建性手术 (1970-1994).
- 使用了功能分类 (I,II,III类型) 和特定的卡蒂尔技术.
- 外科干预包括假肢环植入,带缩短,小册子扩大和 commissurotomy.
主要成果:
- 医院死亡率为2%. 平均随访时间为12年.
- 精算生存率在10年为89%,在20年为82%.
- 在10年后,无需重新手术的比例为82%,在20年后为55%,主要原因是渐进性纤维化.
结论:
- 对于类风湿性 mitra insufficiency 的保守性手术与低的医院死亡率有关.
- 该研究表明,可接受的重新手术率和关于血栓塞栓事件的良好结果.
- 长期结果表明,在风湿性心脏病中,复原性心肌膜手术的可行性.
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