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Claudia Blais¹, Jean G Dumesnil, Richard Baillot

¹Quebec Heart Institute/Laval Hospital, Laval University, Sainte-Foy, Quebec, Canada.

|August 13, 2003

概括

大动脉置换后的假肢患者不匹配 (PPM) 显著增加了短期死亡风险. 仔细选择假肢可以减轻这种风险,特别是在左心室功能减弱的患者中.

科学领域:

心脏病学心脏病学
心脏外科手术心脏外科手术
生物医学工程生物医学工程

背景情况:

大动脉置换 (AVR) 可能导致假肢-患者不匹配 (PPM),因为假肢对于患者的身体尺寸来说太小.
PPM可能会导致跨膜压力梯度升高,这可能会影响患者的治疗结果.

研究的目的:

调查PPM和AVR后的短期死亡率之间的关系.
确定PPM是否是AVR后死亡率的独立预测因素.

主要方法:

索引有效孔面积 (EOA) 计算了1266名AVR患者的PPM严重程度 (不显著,中度,严重).
使用多变量分析,PPM严重程度与30天死亡率相关.
评估了PPM对死亡率的影响与左心室喷射分数相关.

主要成果:

在38%的患者中发现了中度或重度的PPM.
PPM是30天死亡率的强有力的独立预测因素 (P=0.003).
死亡的相对风险增加了中度PPM的2.1倍,严重PPM的11.4倍.

结论:

PPM是AVR后短期死亡率的重要独立预测因子,随着PPM的严重程度而升级的风险.
PPM对死亡率的影响因左心室功能受损而加剧.
在AVR期间的前性策略可以在很大程度上防止中度至重度的PPM.

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