动脉根的手术扩大不会增加动脉置换的手术风险
Rodolfo V Rocha1, Cedric Manlhiot1, Christopher M Feindel1
1Division of Cardiac Surgery, Peter Munk Cardiac Centre, Toronto General Hospital, University of Toronto, Ontario, Canada.
Circulation
|November 24, 2017
概括
在动脉置换 (AVR) 期间手术扩大大动脉根 (ARE) 不会增加死亡率或不良事件. 这种程序是AVR的安全补充,特别是在跨导管门时代.
科学领域:
- 心血管外科
- 心脏门的修复和更换
- 大动脉根部手术
背景情况:
- 在动脉置换 (AVR) 期间手术扩大动脉根 (ARE) 便于植入更大的假体.
- 在跨导管中时代,ARE可能至关重要.
- 将ARE添加到AVR中的操作风险需要评估.
研究的目的:
- 评估接受AVR或没有ARE的患者的早期结果.
- 确定添加到AVR中的增量操作风险.
主要方法:
- 从1990年至2014年接受AVR (AVR+ARE,n=1854; AVR,n=5185) 的7039名患者的回顾性分析.
- 排除患有大动脉解剖和活跃内心炎的患者.
- 用于组比较的物流回归和倾向得分匹配.
主要成果:
- 在接受AVR+ARE的患者中,女性性,先前心脏手术,慢性肺炎和紧急状态的比例较高.
- 在AVR+ARE组的住院死亡率较高 (4. 3%对3. 0%,P=0. 008).
- 调整后的分析显示AVR+ARE没有增加住院死亡率 (OR,1. 03;P=0. 85) 或不良事件的风险.
结论:
- 手术性大动脉根扩大没有增加死亡率或不良事件.
- 在现代手术时代,
- 这些发现是基于迄今为止最大的分析.
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