在侵袭性双内心炎中重建大动脉中枢膜:中期结果
Martin Vobornik1, Salifu Timbilla1, Jan Gofus1
1Department of Cardiac Surgery, Faculty of Medicine and University Hospital in Hradec Kralove, Charles University, Hradec Kralove, Czechia.
Frontiers in cardiovascular medicine
|May 26, 2023
概括
侵袭性双内心炎的手术重建与大心膜损伤提供了最好的生存机会. 尽管风险很高,但在仔细跟进的情况下,中期结果是可以接受的.
科学领域:
- 心血管外科心血管外科
- 传染性疾病 传染性疾病
- 医疗器械 医疗器械
背景情况:
- 侵袭性双内心炎与大动脉中枢膜损伤是一种罕见的,致命的疾病.
- 复杂的手术重建是生存所必需的.
研究的目的:
- 评估双内心炎手术重建的短期和中期结果.
- 评估 Hemi-Commando 和 Commando 程序的有效性.
主要方法:
- 从2014年至2021年进行手术重建的20名患者的回顾性分析.
- 程序包括Hemi-Commando (n=16) 和Commando (n=4) 的程序.
- 收集的数据包括绕道时间,横时间,并发程序和结果.
主要成果:
- 30天死亡率为30% (6/20名患者),在指挥组的死亡率更高 (75%vs19%).
- 1,3年和5年的总生存率分别为60%,50%和45%.
- 四名患者需要重新手术;在5年后,无需重新手术的患者数量为71%.
结论:
- 复杂的手术重建是双膜内心炎和大脑中枢膜损伤患者的唯一可行的选择.
- 中期结果是可以接受的,但长期的门功能需要监测.
- 高度的术后发病率和死亡率需要仔细的患者选择和管理.
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