在老年人中进行手术纠正 mitra 反:结果和最近的改进
Delphine Detaint1, Thoralf M Sundt, Vuyisile T Nkomo
1Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, 200 First St SW, Rochester, Minnesota 55905, USA.
Circulation
|July 19, 2006
概括
与年轻患者相比,患有 mitrale regurgitation (MR) 的老年患者面临更高的手术风险,但在手术后实现类似的预期寿命恢复. 最近的外科进展显著有利于老年人,这表明要仔细考虑老年人的MR手术.
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
- 心脏门疾病 心脏门疾病
背景情况:
- 副腹 (MR) 在老年人中很普遍,通常与高的手术风险和不确定的治疗益处有关.
- 在接受MR手术的老年患者中,手术前的疾病,包括晚期症状和并发症,更为严重.
研究的目的:
- 分析与年轻人队伍相比,老年患者的 mitrale 吐手术的结果.
- 评估随着时间的推移,手术改善对接受MR手术的不同年龄组的影响.
主要方法:
- 对基线特征,手术结果和长期存活率的比较分析.
- 多变量分析调整了预期生存时间,以比较预期寿命恢复.
- 检查手术死亡率,并发症和门修复率的时间趋势.
主要成果:
- 与年轻人群相比,老年患者 (>或 = 75岁) 患有更严重的手术前疾病,但与年轻人群相比,长期预期寿命恢复类似.
- 在所有年龄组中,手术死亡率显著下降,老年人明显改善.
- 随着时间的推移,门维修的可行性急剧增加,特别是对于退行性MR,使所有年龄人口受益.
结论:
- 尽管初始风险较高,老年患者经历了相对较长的预期寿命恢复后的 mitra regurgitation 手术.
- 最近的外科进展显著改善了接受MR手术的老年患者的治疗结果和降低了风险.
- 在耐火性心力衰竭发作之前,老年患者应仔细考虑对心脏部排泄手术.
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