在米特拉手术后新出现的术后心房动:决定因素和对生存的影响
Rishav Aggarwal1, Chesney Siems1, Koray N Potel2
1Division of Cardiothoracic Surgery, Department of Surgery, University of Minnesota Medical School, Minneapolis, Minn.
JTCVS open
|January 11, 2024
概括
手术后心房动 (PAF) 在米特拉手术 (MVS) 后很常见,影响超过60%的患者. 老年,心力衰竭和骨切割预测了长时间的PAF和增加的死亡率,这表明预防性干预可能有利于高风险个体.
科学领域:
- 心血管外科心血管外科
- 心脏电生理学 心脏电生理学
- 临床结果研究研究
背景情况:
- 手术后心房动 (PAF) 是 mitra valve surgery (MVS) 后的常见并发症,影响患者的康复和长期预后.
- 目前用于预防性干预的策略,如左心房附带截肢切断 (LAAA) 或MVS患者的迷宫手术,尚未明确.
- 确定PAF的术前预测因子对于指导有针对性的预防措施至关重要.
研究的目的:
- 确定在隔离MVS后开发任何PAF和长期PAF的术前预测因素.
- 调查PAF与MVS后3年生存率之间的关联.
主要方法:
- 在2011年至2021年期间,对670名接受隔离MVS的患者进行了回顾性分析.
- 排除患有手术前心房,LAAA或肺静脉隔离的患者.
- 多变量回归分析以确定PAF和延长PAF的预测因子,并评估3年生存率.
主要成果:
- 在504名符合条件的患者中,60.2%患有PAF,32.7%患有长期PAF (>30天).
- PAF的独立预测因素包括左心房体积指数,年龄较大,心力衰竭和胸骨切除术.
- PAF与3年死亡率的增加显著相关 (危险比率7.81).
结论:
- PAF是MVS后的常见且显著的并发症,与晚期死亡率的增加有关.
- 老年,晚期心力衰竭和胸腔切除术是长期PAF的关键预测因素.
- 这些已识别的风险因素可以帮助选择可能受益于预防性LAAA或MVS期间切除的患者.
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