中期AVNeo不足的预测因素
Vladlen Bazylev1, Dmitry Tungusov1, Artur Mikulyak1
1Federal Center for Cardiovascular Surgery (Penza), Ministry of Health of the Russian Federation, Penza, Russian Federation.
Brazilian journal of cardiovascular surgery
|October 5, 2023
概括
使用奥扎基手术进行大动脉新皮化 (AVNeo) 是有效的,但叶片不对称性会增加大动脉功能不全的风险. 接受这种手术的老年患者不太可能患AVNeo缺陷.
科学领域:
- 心血管外科心血管外科
- 膜心脏疾病 膜心脏疾病
- 生物材料在医学中的应用
背景情况:
- 大动脉狭窄 (AS) 是一种普遍存在的需要干预的膜性心脏病.
- 大动脉的新皮化 (AVNeo),或奥扎基手术,提供了一个替代传统的门更换使用自性心脏.
- 长期耐用性和影响AVNeo缺陷的因素仍在调查中.
研究的目的:
- 评估自动动心叶片对称性对奥扎基手术后大动脉功能不全的发展的影响.
- 为了确定AVNeo后中期大动脉缺陷的预测因素.
主要方法:
- 分析了经过奥扎基手术的381名AS患者的队列.
- 根据大动脉根对称性,患者被分为两类:对称 (组1) 和不对称 (组2).
- 考克斯回归和卡普兰-梅尔分析被用来评估最长65个月的随访结果.
主要成果:
- 在16名具有对称神经囊的患者和33名具有不对称神经囊的患者中观察到大动脉缺陷.
- 考克斯回归确定了年龄和neocusp不对称性作为晚期术后大动脉缺陷的预测因素.
- 卡普兰-梅尔分析显示,与非对称的患者相比,对称新囊患者的AVNeo缺陷率明显较低 (P=0.006).
结论:
- 不对称的新囊与Ozaki手术后中期大动脉缺陷的风险增加有关.
- 在手术时的老年患者年龄与发展AVNeo缺陷的可能性较低相关.
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