对全身到肺的分流和肺血管阻力升高的管理
Alexandra N Linder1,2, Jill Hsia3,2, Sheila V Krishnan4
1Division of Pediatric Cardiology, Department of Pediatrics, New York Presbyterian-Morgan Stanley Children's Hospital, Columbia University Irving Medical Center, New York, NY, USA.
ERJ open research
|November 8, 2023
概括
边界患者的全身到肺的分流修复,使用向治疗和窗口关闭,改善了肺高血压结果和功能类. 这一策略为精心挑选的个人提供了一个可行的选择.
科学领域:
- 心脏病学 心脏病学
- 儿童心脏病学 儿童心脏病学
- 肺高血压是什么意思 肺高血压
背景情况:
- 系统到肺的分流需要及时修复,以防止不可逆转的肺血管疾病.
- 肺高血压 (PH) 是一个重要的风险因素,需要谨慎的管理策略.
- 这项研究侧重于边界升高的肺血管阻力 (PVR) 患者进行突变修复.
研究的目的:
- 评估针对系统性至肺部分流和边缘性升高PVR的患者个性化管理策略的结果.
- 为了评估手术前向治疗和窗式道关闭在这个患者群体中的有效性.
主要方法:
- 对30名患有全身到肺的分流和基线指数PVR (PVRi) ≥3 WU·m2.2的患者的回顾性图表审查.
- 收集的数据包括人口统计,世界卫生组织功能类 (WHO FC),药物和连续血液动力学数据.
- 根据个性化策略进行结局分析,包括向的肺动脉治疗和窗户式分流关闭.
主要成果:
- 干预后观察到平均肺动脉压 (mPAP) 和PVRi的显著下降.
- 肺和全身流量比率也在修复后显著下降.
- 在大多数患者中,世界卫生组织的功能类从FC II-III改进到FC I.
结论:
- 一个个性化的策略,结合了手术前的向治疗与窗体或部分分流关闭,改善了功能类和临床结果,在精心挑选的边缘PVR患者.
- 这种方法提供了一个有前途的选择,用于管理复杂的先天性心脏病与PH.
- 成功的管理取决于仔细选择患者和量身定制的治疗干预措施.
更多相关视频
相关概念视频
01:27Mitral Stenosis IV: Nursing Management
13
A comprehensive nursing assessment is essential for patients with valvular heart disease, which involves any dysfunction of the heart valves that could impact blood flow and overall heart function.Subjective Data Collection:Chief Complaint and Present Illness: Start with the patient's primary concerns, focusing on the onset, duration, and progression of cardiac symptoms such as dyspnea, fatigue, chest pain, and palpitations.Past Medical History: Collect detailed information on any previous...
13
01:28Mitral Regurgitation IV: Nursing Management
40
Mitral regurgitation (MR) is a condition where the mitral valve does not close properly, leading to the backward flow of blood from the left ventricle into the left atrium during systole. This condition can arise from various causes, including rheumatic fever, infective endocarditis, or degenerative valve disease. Effective nursing management is crucial to optimizing patient outcomes and involves comprehensive assessment and targeted interventions.Comprehensive Patient AssessmentA detailed...
40
01:30Pulmonary Hypertension: Classification and Pathogenesis
194
Pulmonary hypertension (PH) is a severe health condition in which the mean pulmonary arterial pressure increases to 25 mmHg or more, even when the body is at rest. This high pressure in the blood vessels that transport blood from the heart to the lungs can cause various symptoms, including shortness of breath, can lead to right heart failure, and significantly affect the overall quality of life.
There are various classifications for PH, each relating to different underlying causes and also...
There are various classifications for PH, each relating to different underlying causes and also...
194
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
10
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
10
01:30Heart Failure V: Medical Management
9
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
9
01:26Mitral Stenosis III: Medical Management
12
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
12