在患有缺血性 mitra 排泄症的患者中,皮肤透过或手术重血管化
Duk-Hyun Kang1, Byung Joo Sun, Dae-Hee Kim
1Division of Cardiology, Asan Medical Center, College of Medicine, University of Ulsan, 388-1, Poongnap-dong, Songpa-ku, Seoul, Korea 138-736. dhkang@amc.seoul.kr
Circulation
|September 14, 2011
概括
手术复血管化,特别是伴随着 mitra annuloplasty,提供更好的长期无事件存活与皮肤穿冠状动脉干预 (PCI) 相比,缺血性 mitra regurgitation (IMR). 这表明手术是IMR患者首选的重血管化策略.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 干预心脏病学 干预心脏病学
背景情况:
- 缺血额头吐 (IMR) 管理仍然是一个临床挑战.
- 为IMR进行最佳的再血管化策略进行了辩论.
- 皮肤穿透冠状动脉干预 (PCI) 和手术复血管化进行了比较.
研究的目的:
- 为了比较PCI的长期结果与具有显著IMR的患者的手术重血管化.
- 为了评估手术期间同时进行的 mitra annuloplasty 的影响.
主要方法:
- 从1996-2008年对185名IMR患者的回顾性分析.
- 患者接受了PCI (n=66) 或冠状动脉旁路移植手术 (OP组,n=119).
- 倾向性得分匹配用于比较结果,随访时间中位数为54个月.
主要成果:
- 在PCI和手术组之间,存活率或心脏死亡率没有显著差异.
- 手术复血管化显示出明显更高的无事件生存率.
- 在倾向匹配的对中,手术重血管化显著降低了心脏事件风险 (HR,0.499).
- 在外科手术期间进行额外的额外关节取消整形,进一步改善了无事件生存率.
结论:
- 与PCI相比,手术复血管化与IMR的长期无事件生存率相比较高.
- 在接受手术的具有显著IMR的患者中,应考虑同时进行额头骨解体术.
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