由于退行性疾病的 mitra 门修复失败后的重新手术:一个单一的外科医生经验
Aabha Divya1, Oluwanifemi O Akintoye1, Francis Wells1
1Cardiothoracic Surgery, Royal Papworth Hospital NHS Trust, Cambridge, United Kingdom.
JTCVS open
|January 11, 2024
概括
为了修复 mitra 门的重复手术显示出良好的结果. 高龄,紧急手术,混合膜病变,传染性内心炎和COPD增加了这些患者的死亡风险.
科学领域:
- 心血管外科心血管外科
- 心脏外科手术的结果
- 中心门疾病的疾病.
背景情况:
- 越来越多的患者需要在初始关节修复后进行重新手术.
- 之前的 mitra 门修复需要对随后的外科干预进行仔细评估.
研究的目的:
- 评估影响患者死亡率和存活率的因素,这些患者在经过之前的 mitra valve 修复后接受了 mitra valve 手术的重复手术.
- 在这个特定的患者队列中确定结果的术前,术后和术后预测因素.
主要方法:
- 对117名患者进行回顾性分析,这些患者在之前的修复后 (2010-2022) 接受了额头门手术的重新手术.
- 数据收集包括了手术前,手术后和术后的因素.
- 主要结局:整体存活率;次要结局:长时间住院,住院死亡率.
主要成果:
- 晚年 (HR 1.07),紧急重复手术 (HR 1.55),混合 mitra 损伤 (HR 17.09),传染性内心炎 (HR 992.08) 和 COPD (HR 4.3) 与增加的整体死亡率有关.
- 传染性内心炎 (HR 5.83) 和混合性病变 (HR 1.75) 显著增加了住院死亡率.
- 在85名患者中进行了中枢置换 (MVR),在32名患者中进行了中枢修复 (MVr).
结论:
- 经过先前的修复后,即使在单个外科医生手下,对中枢的重新操作也与有利的结果和存活率有关.
- 风险分层是至关重要的,考虑到诸如年龄,急症,并发病症和特定的门病理等因素.
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