老年人的大动脉置换和同时发生的 mitra 反:对生存和功能结果的影响
Christopher J Barreiro1, Nishant D Patel, Torin P Fitton
1Division of Cardiac Surgery, The Johns Hopkins Medical Institution, Baltimore, MD 21287, USA.
Circulation
|September 15, 2005
概括
中度额头吐 (MR) 对接受大动脉置换 (AVR) 的老年患者的长期生存有显著影响. 同时的 mitra 门手术对于那些有内在 mitra 门疾病的人可能是有益的.
科学领域:
- 心血管外科心血管外科
- 老年心脏病学 老年心脏病学
- 膜心脏疾病 膜心脏疾病
背景情况:
- 在接受隔离性大动脉置换 (AVR) 的老年患者中, mitra regurgitation (MR) 的作用需要进一步澄清.
- 在这个人群中,术前中度MR对生存和功能结果的影响还不清楚.
研究的目的:
- 调查手术前中度MR对接受隔离AVR的老年患者的生存和功能结果的长期影响.
- 在这个患者群体中确定与中度MR相关的风险因素和结果.
主要方法:
- 408名老年患者 (>= 70岁) 的回顾性审查,这些患者接受了孤立的AVR.
- 在手术前心声图的基础上分为没有/轻度MR (I组) 和中度MR (II组) 的分层.
- 评估长期生存和功能结果,使用简短的12表格问卷.
主要成果:
- 中度MR被确定为减少长期存活的独立风险因素 (P=0.04).
- 10年生存率在各组之间有显著差异 (40.1%的轻度MR与14.6%的中度MR).
- 虽然功能性MR在AVR后得到改善,但内在MR往往持续或恶化,在不同组之间具有相似的功能结果.
结论:
- 中度额头回是治疗隔离AVR的老年患者长期存活率下降的独立预测因素.
- 建议在患有内在 mitra 病并接受 AVR 的患者考虑同时进行 mitra 手术.
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