心室功能障碍和心房回对前喷泉摩擦的影响
Kathryn O Stack1, Charlotte Schluger2, Amy L Roberts2
1Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
The Annals of thoracic surgery
|July 10, 2023
概括
在Fontan之前的磨损,或未能完成Fontan手术,是很常见的. 心室功能障碍 (VD) 和心室回 (AVVR) 显著增加消耗风险,特别是当它们结合在一起时.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 生产性心脏病 手术 手术 生产性心脏病
- 心脏生理学 心脏生理学
背景情况:
- 上腔肺连接 (SCPC) 是单心室息治疗的一个阶段.
- 许多患者在SCPC后未能完成Fontan手术,称为Fontan前磨损.
- 心室功能障碍 (VD) 和心室膜吐 (AVVR) 是前方顿缩的潜在危险因素.
研究的目的:
- 为了研究中度心室功能障碍 (VD) 和心房回 (AVVR) 对Fontan前磨损的影响.
- 评估VD和AVVR对Fontan前消耗和无移植生存的综合影响.
主要方法:
- 单中心回顾性队列研究.
- 包括接受诺伍德息治疗,随后接受SCPC (2008-2020) 的婴儿.
- 在Fontan之前的消耗被定义为死亡,心脏移植清单或Fontan不适合.
主要成果:
- 在Fontan前的消耗发生在12.7%的患者身上 (34/267).
- 孤立的VD并没有显著增加磨损风险.
- 孤立的AVVR增加了5倍的消耗率;联合的VD和AVVR增加了20倍的几率.
- 联合VD和AVVR显著恶化了无移植生存率.
结论:
- 腹腔功能障碍和心房膜吐的结合是前方顿衰减的主要驱动因素.
- 针对AVVR的疗法可以改善单心室患者的Fontan完成率和长期结果.
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