复合接种植后的大动脉根几何:对未来的门内程序的影响
Paul Werner1, Begüm Sena Kuscu1, Iuliana Coti1
1Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.
The Journal of thoracic and cardiovascular surgery
|June 1, 2023
概括
生物复合移植 (CVG) 显著降低冠状动脉高度,增加未来门内程序期间冠状动脉阻塞的风险. 这凸显了需要改进的技术,以减轻接受CVG的患者的风险.
科学领域:
- 心血管外科心血管外科
- 生物医学工程 生物医学工程
- 放射学 放射学是一门学科.
背景情况:
- 生物复合移植 (CVG) 越来越多地用于大动脉置换.
- 生物假肢故障需要干预,但CVG植入后内 (ViV) 程序的可行性尚不清楚.
- 在CVG后了解大动脉根几何变化对于规划未来干预至关重要.
研究的目的:
- 评估生物复合门移植 (CVG) 植入后大动脉根几何和冠状动脉高度的变化.
- 评估在CVG植入后接受ViV手术的患者冠状动脉阻塞的潜在风险.
主要方法:
- 64名接受生物假体CVG置换的患者的回顾性分析.
- 术前和术后计算机断层扫描血管学 (CTA) 用于大动脉根的评估.
- 虚拟模拟以确定到冠状动脉的距离.
主要成果:
- 冠状动脉高度在CVG植入后显著下降:左冠状动脉 (LCA) 从14.3毫米降至8.7毫米,右冠状动脉 (RCA) 从17.9毫米降至11.3毫米 (P < .001).
- 虚拟到冠状动脉的距离为4.0毫米 (LCA) 和4.6毫米 (RCA).
- 59.4%的患者在未来的ViV手术中面临冠状动脉阻塞的风险 (29.7%的LCA,10.9%的RCA,18.8%的联合).
结论:
- CVG植入导致冠状动脉高度显著降低.
- 大多数接受生物CVG的患者在随后的ViV手术中面临冠状动脉阻塞的潜在风险.
- 需要进一步的研究来开发最佳的冠状动脉再植入技术,并减少阻塞风险.
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