在Fontan操作后的五到十五年的随访
D J Driscoll1, K P Offord, R H Feldt
1Section of Pediatric Cardiology, Mayo Clinic, MN 55905.
Circulation
|February 1, 1992
概括
在Fontan手术后的长期存活受到各种因素的影响. 仔细选择患者至关重要,以改善治疗结果并降低接受这种复杂心脏手术的个体的风险.
科学领域:
- 心脏病学 心脏病学
- 儿童心脏病学 儿童心脏病学
- 遗传性心脏病是一种先天性心脏病.
背景情况:
- 芬坦手术是复杂的先天性心脏缺陷的缓解手术.
- 长期结果和生存率需要持续评估.
研究的目的:
- 为了估计Fontan手术后5至15年的生存和生活质量.
- 为了确定与Fontan手术后患者结果相关的因素.
主要方法:
- 追溯分析了352名在1985年之前接受Fontan手术的患者.
- 评估生存率,恢复率,功能分类和运动能力.
主要成果:
- 整体1年,5年和10年生存率分别为77%,70%和60%.
- 与较低的存活率相关的因素包括特定的心脏异常,早期手术年,异质性,年龄较小,肺压升高,AV门功能障碍和更糟糕的NYHA类.
- 长期并发症包括心律不整 (≥20%),蛋白质损失肠病 (7-10%),以及各种功能性结局,其中34.7%的症状改善,35.8%的症状在5年内死亡或恶化.
结论:
- 芬坦手术的生存率和功能结果受到手术前风险因素的影响.
- 将高风险患者排除在Fontan选择之外,对于改善长期结果至关重要.
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