在小主动脉根中更换大动脉 - - 双叶机械优于单叶机械
Venkatesa Kumar Anakaputhur Rajan1, Ameya Kaskar1, Sendur Selvam1
1#258/A, Bommasandra Industrial Area, Anekal Taluk, Bangalore, 560099 Karnataka India Department of Cardiothoracic Surgery, Narayana Institute of Cardiac Sciences, Narayana Health.
Indian journal of thoracic and cardiovascular surgery
|June 26, 2023
概括
双叶式门在接受主动脉置换的小主动脉根患者中提供了比单叶式门更好的生存和血液动力学效果. 这一发现对于改善患者的治疗结果和避免诸如患者假肢不匹配等并发症至关重要.
科学领域:
- 心血管外科心血管外科
- 生物材料科学 生物材料科学
- 医疗器械 医疗器械
背景情况:
- 患者的假肢不匹配是小主动脉根患者的外科主动脉置换 (SAVR) 的重要并发症.
- 这种并发症可以通过适当的门选择来避免.
研究的目的:
- 在患有小主动脉根的患者中,使用单叶 (ML) 与双叶 (BL) 进行主动脉置换 (AVR) 的早期和中期结果进行比较.
- 评估门类型对患者假肢不匹配和血液动力学性能的影响.
主要方法:
- 在2017年1月至2019年12月期间,对98名患者进行了针对小大动脉根的隔离AVR的回顾性研究.
- 患者接受了TTK奇特拉 (ML) 或圣朱德 (BL) 机械 (17/19毫米).
- 结果被评估使用心声回声和临床随访.
主要成果:
- 与BL组 (56名患者) 相比,ML组 (42名患者) 的患者假肢不匹配率较高,压力梯度较高.
- 早期的结果包括通风持续时间,ICU停留时间和中风发病率是相似的.
- 五年生存率在ML组 (57%) 与BL组 (91.8%) 相比显著较低.
结论:
- 使用小型机械门代替大动脉门,而无需根部扩大,可以获得可接受的早期结果.
- 在这个患者队列中,双叶式机械显示出优越的血液动力学功能和长期存活率,与单叶式相比.
- 老年被确定为死亡的危险因素.
更多相关视频
相关概念视频
Mitral Stenosis III: Medical Management
14
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
14
Aortic Regurgitation I: Introduction
19
IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
19
Heart Valves
5.0K
The human heart is a complex organ with an intricate system of valves that regulate blood flow. There are two main types of valves: atrioventricular (AV) valves and semilunar valves.
The AV valves prevent the backflow of blood from the ventricles to the atria during ventricular contraction. These valves function with the assistance of the chordae tendineae and papillary muscles. When the ventricles are relaxed, the chordae tendineae are slack, allowing blood to flow from the atria into the...
The AV valves prevent the backflow of blood from the ventricles to the atria during ventricular contraction. These valves function with the assistance of the chordae tendineae and papillary muscles. When the ventricles are relaxed, the chordae tendineae are slack, allowing blood to flow from the atria into the...
5.0K
Aortic Regurgitation III: Medical Management
26
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
26
Mitral Valve Prolapse I: Introduction
22
IntroductionThe mitral valve, one of the heart's four valves, regulates blood flow. These valves have flaps that open and close to direct blood properly through the heart and body. During each heartbeat, the flaps open for blood to pass through and seal shut to prevent backflow. Specifically, the mitral valve opens to allow blood flow from the heart's upper left chamber to the lower left chamber. It then closes securely as the lower left chamber contracts to pump blood to the body, preventing...
22


