早期手术与常规治疗在无症状的严重额头骨反时的比较
Duk-Hyun Kang1, Jeong Hoon Kim, Ji Hye Rim
1Division of Cardiology, Cardiac Surgery, Biostatistics, Asan Medical Center, College of Medicine, University of Ulsan, 388-1, Poongnap-dong, Songpa-ku, Seoul, Korea 138-736. dhkang@amc.seoul.kr
Circulation
|February 4, 2009
概括
与保守的管理相比,严重的额头骨流的早期手术显著降低了心脏死亡率和心力衰竭住院治疗. 这种策略可以改善无症状患者的长期结果,同时保持心脏功能.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 临床试验 临床试验
背景情况:
- 在无症状的严重 mitrale 吐时,手术干预的最佳时间仍然不确定.
- 需要对早期手术和传统的管理策略进行比较.
研究的目的:
- 为了比较早期手术干预与无症状患者的长期结果与无症状患者的长期结果,这些患者患有严重的退行性心肌吐和保存的左心室功能.
主要方法:
- 从1996年至2005年,对447名无症状患者进行了前性评估,这些患者患有严重的退行性 mitrale regurgitation 和保存的左心室功能.
- 患者被分为早期手术组 (161) 和常规治疗组 (286).
- 结局点:手术死亡率,心脏病死亡,重复的 mitra 门手术和充血性心力衰竭的紧急入院的组合.
主要成果:
- 1988天的随访中位数显示,早期手术组的7年心脏病死亡率为0%,而传统组的5% (P=0.008).
- 在7年后无事件生存率在早期手术组 (99%) 与常规组 (85%) (P=0.007) 相比,在倾向性得分匹配对中显著更高.
- 肺高血压,年龄和有效的吐孔区域预测了传统治疗组的晚期事件.
结论:
- 早期手术无症状严重退行性心肌反与保存左心室功能是与改善的长期事件率相关的.
- 该策略有效地减少了心脏病死亡率和充血性心力衰竭的住院治疗.
- 早期干预可能会改善临床结果,特别是在患有中枢修复高概率的患者中.
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