在使用心血管磁共振进行修正的法洛特四重症患者肺置换术的术前值
Thomas Oosterhof1, Alexander van Straten, Hubert W Vliegen
1Academic Medical Center, Department of Cardiology, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
Circulation
|July 11, 2007
概括
成年人的肺置换Fallot的四重学纠正可能会导致右心室 (RV) 的体积减少. 手术后RV大小的正常化是可以实现的,当手术前RV终端透缩体积低于160mL/m2或RV终结透缩体积低于82mL/m2时.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 医疗成像医学成像
背景情况:
- 肺置换 (PVR) 对于治疗已纠正的四重法洛特病 (cToF) 的成年人至关重要.
- 为了防止不可逆转的右心室 (RV) 改造,PVR的最佳时机至关重要.
- 手术前的RV体积是预测PVR后RV尺寸变化的关键指标.
研究的目的:
- 为了确定右心室 (RV) 体积的术前值.
- 为了确定RV体积水平,RV大小在肺置换 (PVR) 后不会减少或正常化.
- 评估手术前RV体积和手术后RV重塑在cToF患者之间的关联.
主要方法:
- 一项全国性的前性随访研究包括71名接受PVR的cToF成年患者.
- 心血管磁共振 (CMR) 用于对RV体积的术前和术后评估.
- 进行了统计分析,包括接收器运行特征 (ROC) 分析,以确定预测值.
主要成果:
- 肺置换导致RV体积平均下降28%.
- 在手术后,RV喷射分数没有显著变化.
- 较高的手术前RV体积独立地与PVR后更大的RV体积减少有关,即使考虑到手术RV外流通路的减少.
结论:
- 没有找到一个最终的值,在这个值以上,RV数量在PVR后没有减少.
- 手术前的RV体积是cToF患者PVR后RV改造的显著预测因素.
- 通过PVR可以实现RV终端透缩体积 (<160mL/m2) 或RV终端静缩体积 (<82mL/m2) 的正常化.
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