在婴儿心室隔膜缺陷的修复后,左心室功能障碍
Ehssan Faraji1,2, Elijah H Bolin3,4, Elizabeth G Bond3
1Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Pediatric cardiology
|January 18, 2024
概括
左心室缩功能障碍 (LVSD) 在婴儿心室隔膜缺陷 (VSD) 修复后很常见,但通常在9个月内消失. 手术前的左心室扩张是这种并发症的关键预测因素.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 心脏外科手术 心脏外科手术
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
背景情况:
- 左心室缩功能障碍 (LVSD) 是心室隔膜缺陷 (VSD) 修复后的一个已知的并发症.
- 然而,婴儿的发病率,预测因素和解决模式仍然不完全理解.
研究的目的:
- 为了确定发生率,预测因素和术后LVSD在接受VSD修复的婴儿中解决的时间.
- 确定与LVSD的发展和持续相关的因素.
主要方法:
- 对接受隔离VSD修复的婴儿的回顾性审查 (2001年11月至2019年1月).
- 主要结局:术后的LVSD定义为缩短分数<26%通过M模式心声学.
- 多变量分析包括体重百分比,遗传综合征,利尿剂使用,VSD类型和手术前左心室内维度z-score (LVIDd).
主要成果:
- 在164名婴儿中,62名 (38%) 患有术后LVSD.
- 在9个月内,LVSD在94%的受影响患者中消失.
- 手术前的LVIDd z-score>3.1显著与LVSD的发病率增加和长时间解脱有关.
结论:
- 手术后的LVSD在婴儿的VSD修复后很常见,但通常是短暂的.
- 术前左心室扩张 (LVIDd z-score >3.1) 是术后LVSD的主要独立预测因子.
- 在发生显著的左心室扩张之前,手术关闭VSD可能是有益的.
相关概念视频
01:20Mitral Regurgitation I: Introduction
Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
01:22Mitral Stenosis I: Introduction
Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
01:29Cardiomyopathy V: Interprofessional Care
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...