大动脉绕道手术:高风险大动脉狭窄患者中期临床结果
James S Gammie1, Leandra S Krowsoski, James M Brown
1Division of Cardiac Surgery, University of Maryland Medical Center, Baltimore, MD 21201, USA. jgammie@smail.umaryland.edu
Circulation
|September 17, 2008
概括
大动脉绕道 (AVB) 手术为高风险患者的严重大动脉狭窄提供了可行的治疗方法. 这种程序有效地减少了大动脉狭窄症状,中风和功能障碍的发生率很低.
科学领域:
- 心血管外科心血管外科
- 干预心脏病学 干预心脏病学
- 医疗器械 医疗器械
背景情况:
- 大动脉狭窄 (AS) 是一种需要干预的严重疾病.
- 大动脉绕道 (AVB) 手术,也称为大动脉管,为传统的大动脉置换提供了替代方案.
- 这种方法对患有AS的高风险患者尤为重要.
研究的目的:
- 评估大动脉绕道 (AVB) 手术的疗效和安全性.
- 在高风险患者中,评估AVB作为传统大动脉置换的替代方案.
- 分析术后结果,包括死亡率,中风和功能.
主要方法:
- 在2003年至2007年期间,AVB手术对31名具有症状AS的高风险患者进行.
- 这项研究包括了患有复杂疾病的患者,如以前的旁路移植和甲骨干.
- 关键指标包括心肺绕道时间,交叉时间,外科手术后死亡率,中风发生率,功能和血液动力学变化.
主要成果:
- 患者的平均年龄为81岁,其中71%接受了重新手术,16%患有器上升大动脉.
- 术后死亡率为13% (4/31),最后16名患者没有死亡. 一次中风发生在手术期间.
- 大动脉的平均梯度在AVB后显著下降 (43.5到10.4mm Hg),导管流量为心输出的72%. 功能保持稳定. 功能保持稳定.
结论:
- 大动脉绕道手术对于患有症状性大动脉狭窄症的高风险患者来说是一个有价值的治疗选择.
- 该程序有效地缓解AS通过创建一个可预测的心室外流的分布.
- 在这个队列中,AVB手术显示了不常见的中风和功能障碍率.
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