多血管冠状动脉疾病和严重的动脉硬性大动脉:现实世界的经验
Ivo Gasparovic1, Panagiotis Artemiou1, Andrej Domonkos1
1National Institute of Cardiovascular Diseases, Clinic of Cardiac Surgery, Medical Faculty, Comenius University, 813 72 Bratislava, Slovakia.
Medicina (Kaunas, Lithuania)
|November 25, 2023
概括
脱手术和混合手术为患有上升性大动脉动脉样硬化的患者提供了可比的长期存活率. 建议在初次住院期间进行完整的混合冠状动脉复血管化,以获得最佳的结果.
科学领域:
- 心血管外科心血管外科
- 干预心脏病学 干预心脏病学
- 动脉样硬化研究 动脉样硬化研究
背景情况:
- 对于上升性大动脉动脉样硬化而言,手术复血管化带来了重大挑战.
- 对那些不适合常规复血管化的患者来说,正在探索替代策略.
- 研究了离外科手术和混合方法.
研究的目的:
- 为了比较非式手术与混合手术 (在后期阶段进行皮肤再血管化) 的现实结果.
- 评估这些策略在患有上升性大动脉动脉样硬化的高风险患者中的有效性.
主要方法:
- 单中心回顾性观察性研究 (2010-2021年).
- 91名患有严重上升性大动脉动脉样硬化症的患者接受了离再血管化治疗.
- 随后,有25名患者接受了皮肤再血管化治疗.
主要成果:
- 两组之间在术前,术后或术后特征上没有显著差异.
- 在1年,5年和10年死亡率上没有统计差异 (p = 0.1958).
- 在混合组中,左主冠状动脉疾病的发病率更高.
结论:
- 无论是脱手术还是后期混合手术,都显示出高,可比的长期死亡率.
- 这些策略可能有利于高风险患者.
- 在指数住院期间,建议进行完整的混合冠状动脉再血管化作为最佳治疗方法.
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