最少侵入性手术:对心心膜内膜炎的护理标准
Cristina Barbero1, Marco Pocar1,2,3, Dario Brenna1,2
1Division of Cardiac Surgery, Cardiovascular and Thoracic Department, "Città della Salute e della Scienza di Torino", Molinette Hospital, Corso Dogliotti 14, 10126 Turin, Italy.
Medicina (Kaunas, Lithuania)
|August 26, 2023
概括
通过右侧小型胸腔切除术进行的最小侵入性手术,即使在高风险患者中,也显示了对心交感染性内心炎的有效结果. 这种方法提供了良好的早期和长期生存率,减少了手术创伤和恢复时间.
科学领域:
- 心脏外科手术 心脏外科手术
- 最少侵入性手术的方法
- 传染性内心炎感染性内心炎
背景情况:
- 通过右侧小型胸腔切除术进行的最小侵入性手术 (MIS) 是对关膜疾病的标准,扩展到复杂病例和高风险患者,包括传染性内心炎.
- 对MIS的推理包括减少外科创伤,更快的恢复和更低的感染率.
- 这项研究评估了MIS对中枢感染性内心炎的有效性.
研究的目的:
- 评估对中枢感染性内心炎的微创手术的有效性和早期/晚期结果.
- 评估MIS的可行性,脆弱的,高风险的患者与复杂的额头膜疾病和活跃内心炎.
主要方法:
- 对前性收集的数据 (2007-2022) 进行回顾性分析,这些数据是针对因中枢感染性内心炎而接受MIS的患者.
- 术前评估包括临床病史,解剖学,胸前和食道内心回声,以及全身/血管成像,以选择手术策略.
- 分析了92名患有先天性 (87%) 或假体 (13%) 中心内心炎的患者.
主要成果:
- 92名患者因心交内心炎而接受了右侧小胸切除术;28%的患者曾经接受过心脏手术,20%的患者出现了诸如全身栓塞等并发症.
- 30天死亡率为4.4% (4例死亡);1年和5年生存率分别为90.8%和80.4%.
- 一年和五年免于 mitra valve 重复手术的比率分别为 96.3% 和 93.2%,转换为胸腔切除术的发生率仅为 1.1%.
结论:
- 最少侵入性手术在患有中枢感染性内心炎的高风险患者中显示出有利的早期和长期结果.
- 综合成像 (心声学,血管) 对于患者选择至关重要,使MIS扩展到更生病的患者,包括患有活跃内心炎和败血症的患者.
- 对心脏内膜炎的MIS是安全有效的,与传统方法相比,它具有显著的好处.
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