在患有先天性心脏病的儿童中,机械动脉置换后的结果
Joon Young Kim1, Won Chul Cho2, Dong-Hee Kim1
1Division of Pediatric Cardiac Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Journal of chest surgery
|September 11, 2023
概括
机械动脉置换 (AVR) 在儿童中是安全的,但年龄较小和门尺寸较小会增加不良事件的风险. 仔细的患者选择是最佳结果的关键.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 心血管外科心血管外科
- 生物材料科学 生物材料科学
背景情况:
- 对于儿科大动脉置换 (AVR) 的最佳假体进行了辩论.
- 机械假肢是一种选择,但它们对儿童的长期结果需要研究.
研究的目的:
- 在儿科患者中使用机械假肢调查AVR的结果.
- 确定儿童机械AVR后与不良事件相关的因素.
主要方法:
- 对44名接受机械AVR的儿科患者 (15岁以下) 的回顾性分析.
- 评估的结果包括死亡率,移植,血栓栓塞/出血事件和重新手术.
- 随访时间的中位数为56个月.
主要成果:
- 1年和10年的总生存率分别为92.9%和90.0%.
- 在5年和10年的无不良事件生存率分别为81.8%和72.2%.
- 年龄较小 (<71个月),心肺绕道时间较长,门尺寸较小 (<20毫米) 与不良事件有关.
结论:
- 机械AVR可以安全地在儿科患者中进行.
- 不良事件的危险因素包括年轻的年龄,更长的绕道时间和更小的门尺寸.
- 血栓栓塞或出血并发症是罕见的,但有可能发生.
相关概念视频
Aortic Regurgitation III: Medical Management
24
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
24
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
Aortic Regurgitation II: Clinical Features and Diagnostic Tests
23
Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
23
Heart Valves
4.8K
The human heart is a complex organ with an intricate system of valves that regulate blood flow. There are two main types of valves: atrioventricular (AV) valves and semilunar valves.
The AV valves prevent the backflow of blood from the ventricles to the atria during ventricular contraction. These valves function with the assistance of the chordae tendineae and papillary muscles. When the ventricles are relaxed, the chordae tendineae are slack, allowing blood to flow from the atria into the...
The AV valves prevent the backflow of blood from the ventricles to the atria during ventricular contraction. These valves function with the assistance of the chordae tendineae and papillary muscles. When the ventricles are relaxed, the chordae tendineae are slack, allowing blood to flow from the atria into the...
4.8K
Aortic Regurgitation I: Introduction
10
IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
10
Mitral Stenosis I: Introduction
15
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...
15


