在隔离和并发手术中的内镜大动脉手术
Daniele Zoni1, Giovanni Domenico Cresce1, Tommaso Hinna-Danesi1
1Division of Cardiac Surgery, S. Bortolo Hospital, Vicenza, Italy.
Interdisciplinary cardiovascular and thoracic surgery
|June 16, 2023
概括
内镜大动脉置换 (AVR) 允许通过同一端口进行联合手术,而不会增加死亡率或中风风险. 这种方法为需要多次心脏手术的患者提供了一个安全的选择.
科学领域:
- 心血管外科心血管外科
- 最少侵入性心脏外科手术
背景情况:
- 内镜大动脉置换 (AVR) 是一种微创的技术.
- 在内镜AVR期间通过单个工作端口执行并发程序的可行性需要评估.
研究的目的:
- 评估内镜AVR的早期结果.
- 确定在内镜AVR过程中通过同一个工作端口执行的并发手术相关的风险.
主要方法:
- 在2013年7月至2021年5月期间,对342名接受内镜AVR的患者进行了回顾性分析.
- 对接受单独AVR和接受AVR同时接受手术的患者的结局进行比较.
- 手术访问涉及3-4厘米的工作端口与外围心肺旁路.
主要成果:
- 105名患者 (30.7%) 接受了综合手术,包括冠状动脉绕道,上升大动脉置换和 mitra/tricuspid 门手术.
- 隔离组和组合组之间,住院死亡率 (0.4%对1.9%) 和术后中风率 (1.7%对2.85%) 并没有显著差异.
- 结合组中的心脏起器植入率更高 (7.6%对2.1%,P=0.014).
结论:
- 通过一个单一的工作端口,内镜AVR可以安全地与其他主要心脏手术相结合.
- 同时的手术不会对住院死亡率或中风率产生不利影响.
- 仔细的患者选择和手术规划对于结合内镜AVR手术至关重要.
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