治疗心脏病发作后心室隔膜破裂的当前临床实践:欧洲调查
Daniele Ronco1,2,3, Albert Ariza-Solé4, Mariusz Kowalewski2,3,5
1Congenital Cardiac Surgery Department, IRCCS Policlinico San Donato, San Donato Milanese, Italy.
European heart journal open
|October 16, 2023
概括
延迟的手术修复是欧洲在心脏病发作后心室隔膜破裂 (VSR) 的首选策略. 外体膜氧化越来越多地被用作机械循环支持 (MCS) 来稳定患者在推迟手术之前.
科学领域:
- 心脏病学 心脏病学
- 心血管外科心血管外科
- 医疗器械技术 医疗器械技术
背景情况:
- 心脏病发作后心室隔膜破裂 (VSR) 是一个关键的并发症,未定义的最佳管理策略.
- 不同的治疗政策和可变的结果凸显了对标准化VSR护理的需要.
- 在VSR管理中的欧洲临床实践需要全面的分析.
研究的目的:
- 分析目前的临床实践,管理心室隔膜破裂 (VSR) 在心肌梗塞后的患者在欧洲中心.
- 确定当前的治疗策略,包括外科手术与穿皮疗法,以及干预的时间.
- 评估机械循环支持 (MCS) 在VSR管理中的使用情况.
主要方法:
- 在2022年4月至10月期间,在八个欧洲国家的39个中心进行了一项调查.
- 一个包含38个问题的数字表格收集了关于VSR治疗方面的数据.
- 数据分析的重点是治疗选择,修复时间,血液动力学管理和MCS使用.
主要成果:
- 外科手术是对VSR (71.8%) 的首选治疗方法,而不是穿皮关闭 (28.2%).
- 延迟的手术修复 (87.2%) 是最受欢迎的方法,即使在心脏性休克的情况下,重点是患者的稳定.
- 体外膜氧化 (ECMO) 是最广泛采用的MCS,主要用于手术前,以促进延迟的修复.
结论:
- 延迟的外科干预是欧洲VSR管理的主要策略,无论血液动力学状况如何.
- 外体膜氧化越来越多地被用作VSR手术的桥梁.
- 这项调查为未来的前性研究提供了必要的数据,旨在改善VSR治疗结果.
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