在分阶段的Fontan息治疗期间和之后,需要永久心脏起器植入的布拉迪心律不整
Cornelius Bohn1,2, Thibault Schaeffer1,2, Helena Staehler1,2
1Department of Congenital and Pediatric Heart Surgery, German Heart Center Munich, Technische Universität, Munich, Germany.
Cardiology in the young
|July 27, 2023
概括
布雷迪心律失常是全腔肺连接 (TCPC) 后的一个常见并发症. 心脏起器植入通常是必要的,但它不会对生存或其他与Fontan相关的并发症产生不利影响.
科学领域:
- 心脏病学 心脏病学
- 儿童心脏病学 儿童心脏病学
- 心脏外科手术 心脏外科手术
背景情况:
- 布雷迪心律失常是Fontan手术患者的已知并发症.
- 对于在全腔肺连接 (TCPC) 之前和之后的布拉迪失常症管理,经常需要心脏起器植入.
研究的目的:
- 为了评估布拉迪失常的发病率和Fontan循环患者心脏起器植入后的结果.
- 为了确定与布拉迪失常症相关的因素,需要在这个人群中植入心脏起器.
主要方法:
- 在1994年至2021年期间接受TCPC治疗的620名患者的回顾性分析.
- 评估布拉迪失常发病率,心脏起器植入时间和长期结果.
- 确定心脏起器植入的危险因素.
主要成果:
- 52名患者 (8.4%) 需要进行心脏起器植入,以治疗勃拉迪失常 (鼻功能障碍,心房阻塞,结节逃逸节律).
- 10年免受心脏起器植入的时间为92%; 78%免受改.
- 大动脉的先天纠正转移 (ccTGA) 是TCPC前心脏起器植入的重要风险因素 (OR 6.6).
结论:
- 在TCPC后观察到高率的无心脏起器植入和领先修订.
- ccTGA增加了在TCPC之前植入心脏起器的风险.
- 在Fontan循环中使用心脏起器并没有对存活率或其他重大并发症产生负面影响.
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