节性大动脉根置换:与死亡率和发病率显著相关的长期变量
Varun J Sharma1, Abbie Kangarajah2, Amy Yang2
1Brian F. Buxton Department of Cardiac and Thoracic Aortic Surgery, Austin Health, Melbourne, Australia; Department of Surgery, Melbourne Medical School, University of Melbourne, Melbourne, Australia.
The Journal of thoracic and cardiovascular surgery
|November 22, 2023
概括
节性大动脉根置换提供了优秀的长期效果,低死亡率和重新干预率. 双膜疾病和叶片修复与重新干预有关.
科学领域:
- 心血管外科心血管外科
- 胸部外科手术 胸部外科手术
- 大动脉外科手术
背景情况:
- 门节约性大动脉根置换 (VSARR) 是大动脉根手术中假体门的替代方案.
- 耐久性和影响VSARR结果的因素需要进一步调查.
研究的目的:
- 审查VSARR的中长期结果.
- 为了确定影响生存,重新干预和VSARR后不足的因素.
主要方法:
- 对284名接受VSARR (1999-2022) 的患者进行了回顾性审查.
- 平均随访时间为6.43年 (长达22年).
- 卡普兰-梅尔,考克斯比例危险和细灰分析,用于生存,重新干预和不足.
主要成果:
- 30天的死亡率为1.8%. 10年免于死亡率为88.2%.
- 10年无需大动脉再干预的自由率为79.8%. 有关因素:叶片修复 (HR 8.13) 和双门 (HR 2.23).
- 10年从大动脉衰竭的自由率为80.7%. 双门的再干预通常是由于狭窄;三门,由于不足.
结论:
- VSARR表现出优异的长期耐用性,低死亡率和重新干预率.
- 同时的叶片修复和双主动脉疾病是重新干预的重要预测因素.
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