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对于患有严重左心阻塞的婴儿进行混合息后的结果
Madison B Argo1, David J Barron2, Pirooz Eghtesady3
1Department of Surgery, University of Wisconsin Hospital and Clinics, Madison, Wisconsin, USA; Division of Cardiovascular Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada.
Journal of the American College of Cardiology
|September 27, 2023
概括
混合息为婴儿的严重左心阻塞提供了初始管理. 然而,高死亡率仍然存在,结果因患者因素和诸如管道支架等干预措施而异.
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
- 关键护理医学 关键护理医学
背景情况:
- 混合息,包括双边肺动脉带带和潜在的管道支架,是患有严重左心阻塞的婴儿的主要策略.
- 这种方法在进行最终的外科干预之前是作为临时措施的.
研究的目的:
- 为了确定影响婴儿进行混合息治疗的结果的患者特征.
- 分析与随后的主要临床终点相关的因素,包括双心脏修复,Fontan手术,移植或死亡.
主要方法:
- 对从2005年至2019年期间患有严重左心阻塞的潜在入学婴儿 (n=214) 的分析.
- 利用多变量危险建模与竞争风险方法来评估结果.
- 数据收集自24个机构在先天性心脏外科医生协会队列中的数据.
主要成果:
- 70%的婴儿患有手术前并发症. 总体而言,12年生存率为55%. 总体而言,12年生存率为55%.
- 在混合息后的5年内,9%的患者接受了双心室修复,36%的患者接受了Fontan手术,12%的患者接受了移植,35%的患者死亡.
- 诸如管道支架缺失,年龄较大和特定的心脏解剖学等因素影响了移植风险. 低出生体重,遗传综合征和三腹吐与增加的死亡率有关.
结论:
- 婴儿严重左心阻塞的混合息与高死亡率有关.
- 这种策略可以在特定情况下促进双心室修复,或稳定患者进行单心室息或移植.
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