在单心室重建试验中进行回干预:发生率,风险和结果
Kevin D Hill1, John F Rhodes, Ranjit Aiyagari
1Clinical Research Institute, Duke University Medical Center, 2400 Pratt St., Durham, NC 27705, USA. Kevin.hill@duke.edu
Circulation
|July 19, 2013
概括
在诺伍德手术后,缩是常见的,影响了18%的患者,并与分流类型和弧度梯度有关. 在单心室重建试验中,用于回心的干预措施没有增加1年死亡率.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 生产性心脏手术 手术 生产心脏手术
- 单心室生理学 单心室生理学
背景情况:
- 诺伍德手术后的重造带来了显著的死亡风险.
- 单心室重建 (SVR) 试验在接受诺伍德手术的单右心室患者中研究了两种分流类型.
- 这项研究旨在确定SVR试验中的发生率,风险因素和再治疗的结果.
研究的目的:
- 为了确定在诺伍德手术后重新炼的发生率.
- 为了识别与回扣相关的风险因素.
- 评价患者的结局,包括死亡率和并发性疾病,在患者发展 recoarctation.
主要方法:
- 强迫性被定义为需要导管或手术干预的需要.
- 用单变量和多变量Cox比例危险模型来分析风险因素.
- 分析了SVR试验中549名受试者的数据,重点是变送类型和弧度梯度.
主要成果:
- 18%的SVR受试者 (97/549) 需要进行131次干预,主要是气球动脉整形或手术.
- 缩与右心室 - 肺动脉冲动 (HR 2.0) 和更高的诺伍德排放峰回声 - 多普勒弧度梯度 (HR 1.07每毫米度) 相关.
- 患有重的患者表现出 II 阶段前并发症的增加,包括更高的肺动脉压力和血管抵抗.
结论:
- 在诺伍德手术后,缩是常见的并发症,导致II阶段前的并发症.
- 虽然干预术没有增加1年无移植生存率,但相关的发病率需要进一步调查.
- 了解缩发病率和风险因素对于优化单心室息的结果至关重要.
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