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在缺血性 mitra 排泄中,限制性 annuloplasty 和冠状动脉再血管化导致左心室逆向重塑
Jeroen J Bax1, Jerry Braun, Soeresh T Somer
1Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands. jbax@knoware.nl
Circulation
|September 15, 2004
概括
结合冠状动脉旁路移植和限制性结婚整形术有效治疗缺血性心肌病,显著减少额头肌吐,改善左心室重塑. 这种手术为患有严重额头骨反症的患者提供了优秀的长期结果.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 心血管成像 - 心血管成像
背景情况:
- 有限的数据存在于结合冠状动脉旁路移植 (CABG) 和因缺血性心肌病而进行的限制性结婚整形术.
- 这种综合方法对左心室 (LV) 反向重塑的影响仍然在很大程度上未知.
研究的目的:
- 在患有缺血性心肌病和严重心肌回的患者中评估联合CABG和限制性结婚整形术的疗效.
- 评估这种联合手术策略对心肌吐,左心房维度和LV逆向重塑的影响.
主要方法:
- 51名患有缺血性LV功能障碍和严重腹的患者接受了CABG和限制性annuloplasty与腹环缩小.
- 连续回声心脏学研究评估了额头腔排泄,传导梯度,小册子合并以及LV/左心房尺寸.
- 临床随访评估了纽约心脏协会 (NYHA) 的类别,存活率和2年后的不良事件.
主要成果:
- 在2年的随访期间,所有患者的综合手术导致了最小的残留 mitrale 吐 (级别 1+).
- 观察到LV末缩和末缩维度的显著改善,表明LV重塑的反向.
- 左心房尺寸也显著下降,NYHA类从3.4提高到1.3.
结论:
- 结合限制性结婚整形术和CABG,可以获得出色的临床和心声学结果.
- 该程序有效地消除/最小化双肩吐,并促进显著的反向LV重塑.
- 这种外科手术方法表明了有利的长期结果,包括高生存率和改善的功能类.
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