在动脉开关操作后,大动脉根扩张和大动脉吐的长期预测因素
Marcy L Schwartz1, Kimberlee Gauvreau, Pedro del Nido
1Department of Cardiology, Children's Hospital, 300 Longwood Avenue, Boston, Mass 02115, USA. Marcy.Schwartz@cardio.chboston.org
Circulation
|September 15, 2004
概括
新大动脉根扩张和反可能发生在动脉开关操作后,用于大动脉的d-循环转移. 以前的肺动脉带带和手术时的年龄是这些并发症的危险因素.
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
- 心脏成像 - - 心脏成像
背景情况:
- 新大动脉根扩张 (ARD) 和新大动脉反 (AR) 是大动脉d循环转移 (dTGA) 的动脉开关手术 (ASO) 后的潜在长期并发症.
- 识别ARD和AR的预测因子对于改善ASO后患者的治疗结果至关重要.
研究的目的:
- 在大动脉d循环转移 (dTGA) 患者的动脉切换手术 (ASO) 后,确定新大动脉根扩张 (ARD) 和新大动脉吐 (AR) 的独立预测因子.
主要方法:
- 追溯分析335名在2001年之前接受了dTGA的ASO的患者,他们的心室隔膜或VSD完好无损.
- 纳入标准:在ASO后至少进行一次术后心声图 >1年,没有先前的心房切换手术.
- 卡普兰-梅尔分析和考克斯比例危险建模被用来确定预测因素.
主要成果:
- 在10年后,无ARD的概率为51%;ARD在后期随访中没有进展.
- 之前的肺动脉带 (PAB) 和后来的ASO时间段是ARD的独立预测因素.
- 在ASO (>1年) 时的年龄较大,VSD存在/修复,以及之前的PAB是中度或重度AR的风险因素.
结论:
- 显著的ARD和AR在ASO后随着时间的推移而发展,但ARD通常不是渐进的.
- 上一篇 PAB是ARD的一个重要风险因素.
- 在ASO,VSD和之前的PAB中,年龄较大是AR的风险因素,需要密切监测.
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