在三管手术后进行右心室逆向重塑,以显著的三管吐
Xavier Galloo1,2, Maria Chiara Meucci1,3, Jan Stassen1,4
1Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
Structural heart : the journal of the Heart Team
|June 5, 2023
概括
在三管回手术后显著的右心室逆转重塑与改善的长期生存有关. 更大的右心室末缩面积的减少和改善的分数面积变化预测了更好的结果.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
背景情况:
- 三管 (TV) 手术是在显著的三管吐 (TR) 时进行的.
- 电视手术对右心室 (RV) 维度和功能以及随后的长期结果的影响尚不清楚.
- 评估RV反向改造后电视手术对预测患者的结果至关重要.
研究的目的:
- 为了评估中度或重度TR的TV手术后的RV反向改造.
- 调查RV改造与长期存活之间的关联.
- 为了确定电视手术后死亡率的预测因素.
主要方法:
- 对121名因显著TR而接受电视手术的患者进行分析.
- 基于RV末缩面积 (RVESA) 减少和RV分数面积变化 (RVFAC) 改善的三位数的患者分层.
- 在改造的第三种动物中比较5年死亡率,并调查独立死亡率预测因素.
主要成果:
- 在RVESA减少 (≥17.2%) 和RVFAC改善 (≥2.3%) 的最高三位数的患者显示出明显更好的5年生存率.
- 最好的重塑三角形 (三角形3) 的生存率为RVESA的90%和RVFAC的87%,与较低的三角形相比.
- 显著的RVESA减少和RVFAC改善都独立地与TV手术后更好的生存率相关.
结论:
- 通过减少RVESA和改善RVFAC量化RV逆重塑的程度,与TR的电视手术后的存活率提高有关.
- 实现实质性的RV反向重塑是接受电视手术的患者的积极预后指标.
- 这些发现强调了评估RV重塑对于TR患者长期结果预测的重要性.
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