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Implantation of Total Artificial Heart in Congenital Heart Disease
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在诺伍德手术后的学龄和青少年心力衰竭
William T Mahle1, Rohali Keesari2, Felicia Trachtenberg3
1Children's Healthcare of Atlanta and Department of Pediatrics, Division of Cardiology, Emory University, Atlanta, Georgia.
概括
在青春期之前,心力衰竭事件影响了5%以上的患有低可塑性左心综合征 (HLHS) 的儿童. 虽然心脏移植的结果很好,但许多儿童在12岁时会出现显著的心力衰竭症状.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 遗传性心脏病是一种先天性心脏病.
- 儿科心脏手术 儿科心脏手术
背景情况:
- 低质左心综合征 (HLHS) 对诺伍德手术后的幼儿构成重大风险.
- 对于HLHS患者来说,长期进入青春期的结果没有得到充分的记录.
研究的目的:
- 为了描述心力衰竭事件的轨迹在患有HLHS的儿童到青春期.
- 在幸存者中使用儿科生活质量库存 (PedsQL) 评估症状性心力衰竭.
主要方法:
- 对单心室重建试验的参与者进行分析,他们接受了Fontan手术或在没有它的情况下活到6岁.
- 主要结局:心力衰竭事件 (移植列表或死亡).
- 二级结局:12岁时使用PedsQL.评估心力衰竭症状.
主要成果:
- 7.2%的参与者在12岁之前经历过心力衰竭事件;21人被列为移植,4人死于心力衰竭.
- 与心力衰竭事件相关的因素包括更长的诺伍德医院住院时间,大动脉缩和延迟的Fontan手术.
- 12.2%的受访者报告说,在12岁时经常难以行走.
结论:
- 心力衰竭事件在从学龄前到青春期的缓解性HLHS儿童中很常见.
- 被列为心脏移植的儿童表现出了很好的生存结果.
- 显著数量的缓解性HLHS儿童在12岁时表现出相当大的心力衰竭症状.
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