新生儿肺动脉低成形症 患有四重发育症的新生儿
Christopher J Petit1, Andrew C Glatz2, Andrew B Goldstone3
1Division of Cardiology, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, New York, USA; Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia, USA.
Journal of the American College of Cardiology
|August 9, 2023
概括
患有Fallot症 (sTOF) 和肺动脉低可塑性 (hPA) 的新生儿不会面临增加的死亡率或重新干预的风险. 低塑性肺动脉实际上在这些患者中显示出优异的生长,挑战了先前的看法.
科学领域:
- 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.
- 新生儿手术 新生儿手术
背景情况:
- 新生儿患有Fallot症 (sTOF) 和肺动脉低可塑性 (hPA) 的新生儿被认为是高风险的.
- 关于hPA对sTOF的结果和最佳管理策略的影响的数据有限.
研究的目的:
- 量化hPA对新生儿sTOF.结果的影响.
- 测量管理策略对肺动脉 (PA) 增长的影响.
主要方法:
- 对542名患有sTOF的新生儿 (2005-2017年) 的回顾性审查.
- 通过PA z分数定义的hPA<-2.0 (单边) 和<0 (反边).
- 主要结果:死亡率;次要结果:重新干预和PA增长.
主要成果:
- 188名新生儿 (35%) 患有hPA;随访时间中位数为4.1年.
- 在hPA和正常PA组之间,生存率相似 (调整P=0.25).
- 重新干预在hPA组中更常见 (HR 1.28),但在最终修复后没有差异 (HR 1.21). 在hPA队列中,PA增长优于hPA队列 (P<0.001).
结论:
- 患有sTOF的新生儿中hPA的存在不会增加最终修复后的整体死亡率或重新干预风险.
- 在hPA队列中观察到的高级PA增长挑战了之前的假设.
- 管理策略应考虑这些发现,以改善与hPA的sTOF的结果.
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