长期手术结果的先天性上膜大动脉狭窄:一个系统的审查,元分析和微模拟研究研究
Frederike Meccanici1, Maximiliaan L Notenboom2, Jade Meijssen1
1Department of Cardiology, Erasmus University Medical Centre, Rotterdam, Netherlands.
概括
对于先天性上大动脉狭窄症 (SVAS) 的手术修复显示出改善了预期寿命,但伴随着重复干预的显著终身风险. 对SVAS患者来说,终身心血管监测至关重要.
科学领域:
- 心血管外科心血管外科
- 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.
背景情况:
- 先天性上动脉狭窄症 (SVAS) 是一种罕见的先天性心脏缺陷,导致流出管道阻塞.
- 在SVAS手术修复后的长期结果没有得到充分的记录.
研究的目的:
- 为提供对先天性SVAS手术修复后的长期结果的全面概述.
- 为了估计手术后30年的生存率和并发症率.
主要方法:
- 对报告在SVAS修复后长期结果 (>2年) 的观察性研究进行系统审查.
- 包括20名以上患者的研究,汇集早期风险,晚期事件和时间到事件数据.
- 微模拟建模以估计30年后的结果,并将预期寿命与一般人口进行比较.
主要成果:
- 分析了23篇涉及1472名患者的出版物,平均随访时间为9.0年.
- 聚合的早期死亡率为4.2%,晚期死亡率为0.61%的患者年.
- 估计30年生存率为一般人群的90.7%,心肌梗塞风险为8.1%,再干预风险为31.3%.
结论:
- 与一般人群相比,SVAS的手术修复导致30年生存率降低.
- 重新干预存在相当大的终身风险,通常是由于修复功能障碍.
- 对于SVAS患者,建议对残留狭窄和冠状动脉阻塞进行终身监测.
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