在修复双出口右心室后突然死亡
W K Shen1, D R Holmes, C J Porter
1Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, MN 55905.
Circulation
|January 1, 1990
概括
晚期突然死亡是对双出口右心室进行正手术后的重大风险. 老年,心室动脉节律失常和心脏阻塞是关键的风险因素,需要进行积极的术后管理.
科学领域:
- 心脏病学 心脏病学
- 儿科心脏手术 儿科心脏手术
- 遗传性心脏病是一种先天性心脏病.
背景情况:
- 双出口右心室 (DORV) 的预后随着正手术的进步而得到改善.
- 然而,修复后的晚期心律失常死亡是令人担忧的,其规模和导致因素尚未完全理解.
研究的目的:
- 为了确定DORV.的纠正手术后晚期突然死亡的发生率.
- 为了确定与这种患者群体中晚期突然死亡相关的重大风险因素.
主要方法:
- 一项对118名患者的回顾性分析,这些患者在1965年至1985年期间接受了DORV的纠正手术.
- 分析了89名患者的随访数据,使用Cox比例危险多变量分析来确定晚期突然死亡的危险因素.
主要成果:
- 在22例晚期死亡中,16例 (73%) 是突然发生的,其中50%发生在手术后的一年内.
- 晚期突然死亡的重大风险因素包括手术时的年龄较大,手术前/手术后心室动脉节律障碍,以及三度心房静脉阻塞.
- 诸如手术年份,性别,相关异常和特定的术后导电阻等因素与风险增加无关.
结论:
- 在成功的DORV修复后,晚期突然死亡的发生率特别高.
- 早期的正手术和手术后心律失常和导电缺陷的积极管理对于改善长期结果至关重要.
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