罗斯手术与机械大动脉置换的长期结果:倾向匹配的队列研究
Amine Mazine1, Tirone E David1, Vivek Rao1
1From Division of Cardiovascular Surgery, Peter Munk Cardiac Centre, Toronto General Hospital and University of Toronto, Toronto, ON, Canada.
Circulation
|August 7, 2016
概括
罗斯手术和机械主动脉置换 (AVR) 的存活率和重新干预率相似. 然而,罗斯手术显著降低了成人心脏病死亡率,中风和出血风险.
科学领域:
- 心血管外科
- 胸部手术
- 大人的心脏手术
背景情况:
- 对于年轻和中年人来说,最好的主动脉替代品仍未确定.
- 这项研究比较了罗斯手术与机械主动脉置换 (AVR) 的长期结果.
研究的目的:
- 将罗斯手术与机械AVR的长期疗效和安全性进行比较.
- 评估生存率,重复干预率以及死亡率,中风和出血等不良事件.
主要方法:
- 对258名接受罗斯手术和1444名接受机械AVR (1990-2014) 的回顾性分析.
- 倾向性得分匹配创建了208个可比对进行分析.
- 平均随访时间为14.2年,在一个专门的机构.
主要成果:
- 罗斯手术和机械AVR的总生存率是相当的 (P=0. 83).
- 罗斯手术显示,与心脏和门相关的死亡率有所改善 (P=0. 03).
- 在罗斯手术后,长期无中风和严重出血的情况明显高 (P< 0. 001).
结论:
- 罗斯手术和机械AVR显示了可比的长期存活率和重新干预率.
- 罗斯手术在减少心脏病死亡率,中风和出血事件方面具有显著的好处.
- 在经验丰富的中心, 罗斯手术是青少年和中年人的大动脉置换的一个很好的选择.
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