随机对照试验:CAMRA CardioLink-2研究
Vincent Chan1,2, C David Mazer3,4,5, Faeez Mohamad Ali6
1Division of Cardiac Surgery, University of Ottawa Heart Institute, ON, Canada (V.C., M.R., T.M.).
Circulation
|October 5, 2020
概括
使用叶片切除或叶片保存进行的手术修复显示了12个月的叶片吐和梯度的类似结果. 这项研究发现,与保存相比,切除叶片并没有增加功能性心肌狭窄的风险.
科学领域:
- 心血管外科
- 心脏外科
- 胸部手术
背景情况:
- 对于因倒而导致的 mitrale 吐而进行的传单切除与保存,存在均衡.
- 为了比较这些技术,进行了一项随机对照试验,重点是功能性缩.
研究的目的:
- 为了比较叶片切除与叶片保存在外科修复退行性腹的疗效.
- 通过传导梯度测量这些技术对功能缩的影响.
主要方法:
- 在7个中心随机分组了104名患有退行性腹症的患者.
- 排除标准包括前侧叶片/ 门外和混合门疾病.
- 主要终点是修复后12个月的峰值运动时的平均心肌梯度.
主要成果:
- 在12个月后,在运动高峰时 (9. 1±5. 2毫米平与8. 3±3. 3毫米平;P=0. 43) 或静止时的平均传导梯度没有显著差异.
- 在3名患者中发生了中度吐 (叶片切除) 和2名患者中发生了叶片保存.
- 在两组之间记录了类似的6分钟步行距离 (451±147米与481±95米;P=0.27).
结论:
- 在手术后的12个月内,切除和保存以修复心肌变的片段会产生类似的传导梯度.
- 与保存相比,这些发现不支持功能性缩的风险增加.
- 这项研究具有足够的动力来检测 mitra 梯度的显著差异.
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