在65岁及以上的患者中,皮肤通透的额头膜切除术的即时和长期结果
E M Tuzcu1, P C Block, B P Griffin
1Department of Medicine (Cardiac Unit), Massachusetts General Hospital, Harvard Medical School, Boston 02114.
Circulation
|March 1, 1992
概括
皮肤穿透气球美特拉切除术 (PMV) 为患有美特拉狭窄症的老年患者提供安全有效的结果. 使用心声学和光学进行仔细的患者选择是成功结果的关键.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 膜心脏疾病 膜心脏疾病
背景情况:
- 在99名老年患者 (≥65岁) 中分析了皮肤穿气球中膜切除术 (PMV) 的结果.
- 81名女性和18名男性,平均年龄为72岁.
- 患者经常出现纽约心脏协会 (NYHA) 的高级III/IV类,并发病症和中枢结石化.
研究的目的:
- 评估老年患者PMV的直接和长期结果.
- 确定PMV后成功和生存的预测因素.
- 为了确定PMV在这个特定的人群中的安全性和有效性.
主要方法:
- 对99名接受PMV治疗的患者进行了回顾性分析.
- 程序成功的评估定义为:双肩膜区域,双肩吐和短路.
- 多变量分析以确定成功和生存的预测因素.
- 长期随访,包括精算生存率和无事件生存率.
主要成果:
- 46名患者 (46.5%) 的手术成功.
- 这些并发症包括手术死亡 (3),心周栓塞 (5),血栓栓塞 (3).
- 成功的PMV组显示出明显更好的3年精算生存率 (79%对62%),没有MV替代的生存率 (71%对41%) 和无事件的生存率.
- 低回声心脏图谱得分,缺乏MV化,低NYHA等级和较低的压力预测了更好的结果.
结论:
- 在选定的老年患者中,PMV是一种安全的程序,具有良好的即时和长期结果.
- 心声学评估和光镜查化对于患者的选择至关重要.
- 优化患者选择可以在老年人中改善PMV后的治疗结果和生存率.
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