死亡,重新手术,和后期心肺功能后的骨修复
Takaya Hoashi1, Kenta Imai1, Naoki Okuda1
1Department of Pediatric Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan.
JTCVS open
|July 10, 2023
概括
截状动脉的晚期手术结果显示,30年生存率为68.5%,而截状的反会影响预后. 长期幸存者通常会经历稍微减少的运动耐受性.
科学领域:
- 心血管外科心血管外科
- 儿童心脏病学 儿童心脏病学
- 遗传性心脏病是一种先天性心脏病.
背景情况:
- 动脉是一个罕见的先天性心脏缺陷,需要手术干预.
- 手术修复后的长期结果和预后因素对于患者管理至关重要.
研究的目的:
- 为了评估骨干动脉修复的晚期手术结果.
- 确定影响生存率和恢复率的风险因素.
- 评估长期幸存者的功能状态,包括运动能力.
主要方法:
- 在1978年至2020年间,对50名连续接受手术的动脉骨干患者进行了回顾性队列研究.
- 主要结局包括死亡和重新手术;次要结局通过跑步机测试评估晚期的临床状态和运动能力.
- 统计分析确定了生存和重新操作的风险因素.
主要成果:
- 经过骨干动脉修复后的30年生存率为68.5%.
- 显著的骨干回被确定为生存 (P=.030) 和重新手术 (P=.001) 的风险因素.
- 在15年内,无死亡或重新手术率为35.8%;长期幸存者 (n=12) 显示氧气吸收峰值为预测正常水平的70.2%.
结论:
- 骨干膜反显著影响存活率和复手率,突出了改善骨干膜手术技术的需要.
- 虽然长期存活是可以实现的,但有一部分患者的运动耐受性略有降低,这强调了持续监测和生活质量评估的重要性.
相关概念视频
Cardiomyopathy VII: Pre and Post Operative Nursing Management
16
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
16
Tracheostomy: Procedure and Tubes
755
A tracheostomy is a surgical procedure that creates an artificial opening into the trachea, typically at the second or third cartilaginous ring level. This opening allows the insertion of a tracheostomy tube, which can replace an endotracheal tube, provide mechanical ventilation, bypass an upper airway obstruction, or remove accumulated tracheobronchial secretions.
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
755
Tracheostomy Decannulation
243
Tracheostomy decannulation is a significant milestone in the liberation of mechanically ventilated patients. Despite its importance, there is no universally accepted protocol for this procedure. This demands an evidence-based, individualized approach.
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
243
Oxygen Delivering System III: Tracheostomy and T-piece
1.3K
Oxygen delivery is critical in clinical care, especially for patients with respiratory disorders or those undergoing surgical procedures. Various systems, such as tracheostomy and the T-piece, deliver oxygen to the lungs, ensuring adequate arterial oxygenation.
Tracheostomy
A tracheostomy is a surgically created opening (stoma) in the anterior part of the trachea. It is used to establish a patient airway, bypass an upper airway obstruction, simplify the removal of secretions, permit long-term...
Tracheostomy
A tracheostomy is a surgically created opening (stoma) in the anterior part of the trachea. It is used to establish a patient airway, bypass an upper airway obstruction, simplify the removal of secretions, permit long-term...
1.3K
Aneurysm III: Interprofessional Care
10
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
10
Cardiac Catheterization II: Right Heart Catheterization
55
Right Heart Catheterization: An OverviewRight heart catheterization is an invasive diagnostic procedure that measures right-sided cardiac and pulmonary artery pressures, calculates cardiac output, and identifies intracardiac shunts. It provides detailed hemodynamic data essential for diagnosing and managing various cardiovascular conditions, such as pulmonary hypertension.Access SitesCommon access sites for right heart catheterization include the internal jugular vein in the neck region, the...
55


