在肺门置换心脏律不整手术后,心脏律不整复发的危险因素
Yuji Tominaga1,2, Masaki Taira1, Takuji Watanabe1
1Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
JTCVS open
|July 10, 2023
概括
在Fallot修复手术四重症后,复发性心房律不整与右心房体积增加有关. 这一发现有助于确定肺置换和心律失常手术的时间,以获得更好的患者结果.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 电子生理学 电子生理学
背景情况:
- 大心律失常是法洛修复四重症后的长期并发症的主要原因.
- 外科手术后心房律乱复发的数据有限.
研究的目的:
- 为了确定心房失常症复发的风险因素,在肺置换 (PVR) 和同时发生失常症手术后,在患有Fallot四重律修复的患者中.
主要方法:
- 74名经过修复的Fallot四重症患者进行PVR的回顾性审查.
- 对22名患者的分析,这些患者还接受了心房律乱手术 (修改的考克斯迷宫III或右侧迷宫).
- 考克斯的比例风险模型用于评估影响复发的术前参数.
主要成果:
- 随访时间中位数为9.2年;没有观察到心脏病死亡或复原PVR.
- 在11名患者中发生了心房律乱的复发.
- 无复发率在5年后为68%,在10年后为51%.
- 手术前右心房体积指数的增加是一个显著的危险因素 (HR1.04,P=.009).
结论:
- 手术前的右心房体积指数与心房律乱的复发有关.
- 这一指标可以帮助优化PVR和心房失常手术的时间.
相关概念视频
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 Stenosis III: Medical Management
13
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...
13
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
48
Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
48
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
Dysrhythmias II: Classification of Tachyarrhythmias
12
Tachyarrhythmias are a type of dysrhythmia where the heart rate exceeds 100 beats per minute. Here are some common types of tachyarrhythmias:Sinus TachycardiaSinus tachycardia originates from increased impulses from the sinus node, leading to an elevated heart rate. It is often triggered by stress, fever, or exercise.Patients may experience palpitations, a sensation of a racing heart, dizziness, and chest discomfort.Causes and Risk Factors: Common causes include physical exertion, emotional...
12
Disturbances in Heart Rhythm
1.0K
Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow...
Arrhythmias are categorized by their speed, rhythm, and origin. A slow...
1.0K


