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为所有患者进行门节约性大动脉根置换?

Tristan Ehrlich¹, Karen B Abeln¹, Lennart Froede¹

¹Department of Thoracic and Cardiovascular Surgery, Saarland University Medical Center, Homburg/Saar, Germany.

The Journal of thoracic and cardiovascular surgery

|September 11, 2023

概括

节能根置换 (VSRR) 提供了良好的结果,但随着61岁以上的年龄和并发症的增加,生存率下降. 与门相关的无并发症生存率在各个年龄段仍然有利.

科学领域:

心血管外科心血管外科
大动脉门外科手术
大动脉根的替代术

背景情况:

节能根置换 (VSRR) 与有利的生存率和较低的关相关并发症 (VRCs) 有关.
患者并发症和年龄对VSRR结果的影响需要进一步调查.

研究的目的:

分析VSRR后的生存率和VRC的频率.
评估患者并发症和年龄对VSRR结局的影响.

主要方法:

一组1156名患者在1995年至2021年期间接受双或三大动脉的VSRR治疗.
基于患者的并发症和手术时的年龄,对生存率和VRCs的分析,并使用ROC分析来确定年龄截止.
平均随访时间为6.7年,完成率为95%.

主要成果:

平均15年生存率为74.7%. 死亡的患者年龄较大,并患有更多的并发病 (例如冠状动脉疾病).
61岁以上的年龄是死亡率的唯一显著预测因素 (P < .001).
15年生存率为87.1%的患者<61年对比55.3%的患者>61年. 在15年内,无VRC存活率为66.8%,年轻患者的比率更高.

结论:

在VRCs的低发病率下,VSRR表现出极好的耐用性.
患者年龄>61岁和并发症,特别是冠状动脉疾病,与生存率下降有关.
尽管与年龄相关的生存差异,VSRR提供良好的免于门相关的并发症.

关键词:

大动脉的动脉.动脉动脉根的动脉动脉根.大动脉门的大动脉门上升的大动脉上升幸存率幸存率生存率门节约手术是如何进行的

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