对假体大动脉内心炎进行重置动脉根置换:大动脉移植的影响
Dov Levine1, Parth Patel2, Yanling Zhao1
1Division of Cardiothoracic and Vascular Surgery, Columbia University Medical Center, New York, NY, USA.
概括
假内心炎的重复性大动脉根置换是复杂的. 之前接受过大动脉手术的患者经历了更多的术后中风和功能衰竭,但与之前仅接受过大动脉置换的患者相比,长期存活率和重新手术率相似.
科学领域:
- 心血管外科心血管外科
- 传染性疾病 传染性疾病
- 医疗技术 医疗技术 医学技术
背景情况:
- 假内心炎 (PVE) 带来了外科手术的挑战,特别是在已有大动脉移植的患者中.
- 之前的大动脉移植对PVE复手性大动脉根置换 (ARR) 的结果的影响尚不清楚.
研究的目的:
- 为了比较在先前进行大动脉手术 (包括移植) 的患者与先前隔离大动脉置换的患者中,对PVE进行重复性大动脉根置换的结果.
主要方法:
- 在2004年至2021年期间,对130名接受PVE再手术ARR的患者进行了回顾性分析.
- 根据先前的大动脉手术 (AO) 或先前隔离的大动脉置换 (AV) 的情况,患者被分组.
- 使用逆倾向治疗权重和卡普兰-梅尔生存分析.
主要成果:
- 在匹配后,AO组的中风发病率较高 (12.4%vs0.9%) 和需要透析的功能衰竭 (11.5%vs2.5%).
- 住院死亡率在两组之间是可比的 (21.5%的AO与18.6%的AV).
- 五年生存率 (68.9%的AO与62.7%的AV) 和重新手术率 (6.3%的AO与6.1%的AV) 相似.
结论:
- 对PVE的再手术ARR是一种高风险的手术,在先前进行大动脉手术的患者中,术后发病率增加.
- 尽管最初的发病率较高,但在最初的手术中存活的患者中,长期存活率和重新手术率在各组之间是可比的.
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