总异常肺静脉连接:国际人口研究的形态和结果
Anna N Seale1, Hideki Uemura, Steven A Webber
1Royal Brompton Hospital, London, United Kingdom.
Circulation
|December 8, 2010
概括
在完全异常的肺静脉连接修复后的晚期死亡与肺静脉阻塞 (PVO) 有关. 手术前的特征预测了接受这种手术的婴儿的PVO和存活率.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 生产性心脏病 手术 手术 生产性心脏病
- 医学成像在心脏病学中的医学成像.
背景情况:
- 在完全异常肺静脉连接 (TAPVC) 修复后的晚期死亡通常是由于肺静脉阻塞 (PVO).
- 了解TAPVC的形态谱和相关的风险因素对于改善结果至关重要.
- 这项研究调查了TAPVC.婴儿死亡和术后PVO的风险因素.
研究的目的:
- 描述全异常肺静脉连接 (TAPVC) 的形态变异.
- 为了确定与TAPVC修复后的死亡率和术后肺静脉阻塞 (PVO) 相关的风险因素.
- 提高 TAPVC 婴儿的生存率和减少 TAPVC 婴儿的并发症.
主要方法:
- 在英国,爱尔兰和瑞典的19个儿科心脏中心进行了回顾性,国际,基于人口的研究.
- 包括1998年至2004年期间所有患有TAPVC的活产婴儿,但不包括有单静脉循环或心房异构的婴儿.
- 审查所有可用的数据和成像,以分析连接类型,相关异常和结果.
主要成果:
- 该研究分析了422例TAPVC病例,其中心脏上升 (48.6%) 是最常见的连接类型.
- 手术治疗患者的三年生存率为85.2%;死亡的风险因素包括早期手术,低塑性/静脉静脉,复杂的心脏病变和术后PVO.
- 手术后PVO发生在14.8%的患者中,显著影响了生存率 (58.7%在3年),手术前的低塑性/静脉静脉和缺乏共同的汇合是关键风险因素.
结论:
- 手术前的临床和形态特征是术后肺静脉阻塞 (PVO) 和患者存活率的重要预测因素.
- 早期识别风险因素可以指导外科手术时间和总异常肺静脉连接 (TAPVC) 的管理策略.
- 进一步研究缓解PVO发展是有必要的,以改善TAPVC修复的长期结果.
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