老年患者内镜 mitra 门手术的早期结果:一个大批量单一中心体验
Jonas Pausch1, Oliver D Bhadra1, Xiaoqin Hua1
1Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany.
Frontiers in cardiovascular medicine
|December 14, 2023
概括
内镜 mitrale 手术 (MVS) 是一个可行的选择,老年患者 (≥75岁) 与 mitrale 吐. 尽管手术风险较高,但结果有利,支持在心脏团队讨论中考虑它.
科学领域:
- 心脏外科手术 心脏外科手术
- 最少侵入性手术的方法
- 老年心脏病学 老年心脏病学
背景情况:
- 内镜 mitra 手术 (MVS) 是对 mitra 吐 (MR) 的一个成熟的治疗方法.
- 随着患者年龄的增长,MVS中的外科风险会增加,这引发了对老年人的结果的担忧.
- 越来越多地使用过导管方法,但内镜MVS在老年人群中的作用仍在研究中.
研究的目的:
- 与年轻患者相比,评估老年患者 (≥75岁) 内镜MVS的术后结果.
- 为了确定晚年是否是对最小侵入性 mitra 门手术的禁忌.
- 评估内镜MVS在高风险老年人群中的安全性和有效性.
主要方法:
- 在2016-2022年期间,对756名接受MR (≥2) 内镜MVS的患者进行了回顾性分析.
- 分为老年人 (≥75岁,n=91) 和对照组 (<75岁,n=665).
- 内镜MVS通过右侧前侧小胸切除术与3D摄像头可视化进行.
主要成果:
- 老年患者有更高的手术风险 (STS-PROM 1.9%与0.4%) 和更多的并发症 (高血压,糖尿病,CAD,AFib).
- 尽管风险增加,但手术后并发症 (血液透析,低心力输出,中风,心脏病发作) 和30天死亡率 (2.2%对0.4%) 较低,并且在不同组之间可比.
- 老年人中中心的修复率略低 (85.7%对93.8%),左心房关闭的频率更高.
结论:
- 内镜MVS在75岁以上的患者中显示出良好的术后结果,即使并发症和手术风险增加.
- 这种微创手术方法对于经过精心挑选的MR老年患者来说是一个有价值的治疗选择.
- 在常规心脏团队讨论中,应考虑内镜MVS对于需要米特拉干预的符合条件的老年患者.
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