由于生物假体中膜耐用性更好,中膜更换年龄指南是否应该降低?
Matthew Romano1, Patrick M McCarthy2, Abigail S Baldridge2
1Department of Cardiac Surgery, University of Michigan, Ann Arbor, Mich.
The Journal of thoracic and cardiovascular surgery
|October 15, 2023
概括
在年轻的患者中,牛心围膜关置换显示了耐用性,为机械提供了替代方案. 这项研究表明,关于按年龄选择门的指导方针可能需要修订.
科学领域:
- 心血管外科心血管外科
- 生物材料科学 生物材料科学
- 临床结果研究研究
背景情况:
- 目前对关节置换 (MVR) 的指导方针缺乏针对生物假体与机械的年龄特定建议.
- 牛心周门是机械门的替代品,可以避免抗凝风险.
- 患者年龄是生物假体门耐用性和重新干预率的关键因素.
研究的目的:
- 根据患者的年龄来评估牛心周中枢的耐用性.
- 评估与年龄相关的结构恶化 (SVD) 导致的重新干预的风险.
- 为修订有关MVR门选择的当前临床指南提供数据.
主要方法:
- 在两个主要的学术中心,从2004年到2020年间对1544名接受生物假体MVR的患者进行了回顾性分析.
- 通过2022年6月收集的后续数据,通过年龄分位数比较结果.
- 分析的重点是结构的恶化和重新干预率.
主要成果:
- 在40至70岁的患者中没有观察到SVD的显著差异.
- 对SVD进行MVR再干预的累计发病率为10年6.2%和12年9.0%.
- 再次干预后的30天死亡率为门内的4.7%,再操作的6.4%.
结论:
- 牛心周中枢门表现出耐用性,特别是在年轻的患者队列中.
- 生物假体提供了一个可行的选择,可能降低与机械抗凝相关的风险.
- 这些发现支持重新评估以年龄为基础的对米特拉置换策略的指南.
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