穿皮肺植入:不断发展的技术和学习曲线对临床结果的影响
Philipp Lurz1, Louise Coats, Sachin Khambadkone
1UCL Institute of Child Health, London, United Kingdom.
Circulation
|April 9, 2008
概括
穿皮肺植入有效治疗右心室外流管功能障碍,显著降低压力和梯度. 这种非手术方法可能会降低肺导管患者未来心脏手术的需要.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 生物医学工程 生物医学工程
背景情况:
- 穿皮肺植入 (PPVI) 于2000年出现,作为右心室外流通道 (RVOT) 功能障碍手术的不那么侵入性的替代方案.
- 在患有先天性心脏病和导管问题的患者中,RVOT功能障碍往往需要进行干预.
研究的目的:
- 评估PPVI在RVOT功能障碍患者的疗效和长期结果.
- 评估PPVI对血液动力学参数的影响以及重新干预的必要性.
主要方法:
- 一组155名患有RVOT狭窄和/或吐的患者在2000年9月至2007年2月期间接受了PPVI.
- 血液动力学参数,重复手术率,重复干预率和存活率在284个月的中位随访期内被分析.
主要成果:
- PPVI导致右心室缩压 (63至45毫米平) 和RVOT梯度 (37至17毫米平) 显著降低.
- 在70个月后,长期无需重新手术的比例为70%,而在70个月后,无需通过导管重新干预的比例为73%.
- 83个月的生存率高达96.9%.
结论:
- 在大多数情况下,PPVI成功地避免了手术RVOT修改.
- 这种微创手术有可能减少患者一生中累积的手术数量,特别是那些有右心室到肺动脉导管的人.
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