术前因素与三巴置换术后不良结果相关
Yan Topilsky1, Amber D Khanna, Jae K Oh
1Divisions of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.
Circulation
|April 27, 2011
概括
如果在先进的心力衰竭之前进行,严重吐的三管置换具有可接受的手术死亡率. 晚期死亡率与较高的查尔森指数,心肌功能降低和严重的纽约心脏协会等级有关.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
背景情况:
- 在严重的三管吐后,影响三管置换后结果的术前因素尚不清楚.
- 严重的三回需要及时干预,以改善患者的预后.
研究的目的:
- 为了确定与死亡率和不良结果相关的术前因素,在患者进行三管置换严重三管吐.
- 评估患者特征和心声回声学参数对短期和长期结果的影响.
主要方法:
- 对189名因严重的三回而进行三管置换的患者进行了回顾性分析.
- 统计分析包括赔率比率,置信区间和危险比率,以确定死亡率和不良事件的独立预测因素.
- 评估回声心脏学参数,包括心肌性能比率的正确指数,以及像查尔森指数这样的临床分数.
主要成果:
- 术后死亡率为10%,与大动脉内气球使用和纽约心脏协会 (NYHA) 第四类症状相关.
- 在长期随访时,37%的患者死亡,3%需要重新手术,21.7%因心力衰竭重新入院.
- 所有原因死亡率的独立预测因素包括较高的查尔森指数,较短的心肌性能比率右指数和NYHA类IV.
结论:
- 如果在先进的心力衰竭之前进行,可以在可接受的手术死亡率下进行三管置换.
- 晚期死亡率与高的手术前查尔森指数,心肌性能比率的右侧指数降低,以及高级的NYHA类显著相关.
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