与无门的Sano管道相比,门的Sano管道在诺伍德操作后改善了即时的结果
Halil Beqaj1, Nimrod Goldshtrom2, Alexandra Linder3
1Section of Pediatric and Congenital Cardiac Surgery, Division of Cardiac, Thoracic, and Vascular Surgery, Department of Surgery, Columbia University Medical Center, New York-Presbyterian Morgan Stanley Children's Hospital, New York, NY.
The Journal of thoracic and cardiovascular surgery
|September 4, 2023
概括
与非管相比,管的Sano管道改善了对左心脏低可塑性综合征的诺伍德手术后的结果,导致更好的器官恢复和持续的心室功能.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 生产性心脏手术 手术 生产心脏手术
- 医疗设备创新 医疗设备创新
背景情况:
- 诺伍德手术是对低可塑性左心综合征 (HLHS) 的关键干预.
- 赛诺管道用于增加肺血流,但门与无门赛诺管道的影响需要进一步调查.
- 优化HLHS患者的治疗结果对于长期生存和生活质量至关重要.
研究的目的:
- 为了比较使用有门的Sano导管与未门的Sano导管在接受HLHS诺伍德手术的新生儿中的临床结果.
- 评估门赛诺对末端器官功能,心室功能和再干预率的影响.
主要方法:
- 对50名接受诺伍德手术的HLHS新生儿进行了回顾性审查.
- 25名患者在2013年至2022年期间接受了门式桑诺管道,25名患者在2013年至2022年期间接受了非门式桑诺管道.
- 主要结局包括术后末端器官和心室功能;次要结局包括心脏事件,死亡率和重新干预.
主要成果:
- 门的Sano组表现出明显较低的峰值和手术后的第1天乳酸水平,更短的尿路时间和更早的肠道养.
- 在有门的Sano组中,直到格伦手术 (1vs8) 之前,肺动脉再干预的情况较少.
- 门的Sano组在术后表现出改善的心室功能恢复和持续的格伦前功能,与非门组不同.
结论:
- 在诺伍德手术中使用门式桑诺管道与改善多器官恢复有关.
- 门赛诺管道导致更好的心室功能恢复和格伦手术前更少的肺动脉再干预.
- 在67%的有门的Sano导管中,通过格伦前心声学观察到有能力的门.
相关概念视频
Mitral Stenosis I: Introduction
16
Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
16
Mitral Stenosis III: Medical Management
12
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
12
Cardiomyopathy VII: Pre and Post Operative Nursing Management
16
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
16
Mitral Valve Prolapse II: Assessment and Management
21
IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular...
21
Esophageal Varices-I: Introduction
176
Esophageal varices are dilated, tortuous veins which are found mainly in the submucosa of the lower esophagus but which may also appear higher up or extend into the stomach. They develop due to increased pressure in the portal venous system, often as a result of liver cirrhosis. This condition scars and damages the liver, impeding normal blood flow through the portal vein. To compensate, blood seeks alternative pathways, forming fragile new vessels (varices) in the esophagus and stomach. These...
176
Tracheostomy: Procedure and Tubes
716
A tracheostomy is a surgical procedure that creates an artificial opening into the trachea, typically at the second or third cartilaginous ring level. This opening allows the insertion of a tracheostomy tube, which can replace an endotracheal tube, provide mechanical ventilation, bypass an upper airway obstruction, or remove accumulated tracheobronchial secretions.
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
716


