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发生率,风险因素和结果与永久心脏起器植入后的三管门手术相关
Joseph Kassab1, Serge C Harb1, Milind Y Desai1
1Department of Cardiovascular Medicine Heart, Vascular and Thoracic Institute, Cleveland Clinic Foundation Cleveland OH USA.
Journal of the American Heart Association
|January 31, 2024
概括
在三膜手术 (TVS) 后,永久心脏起器 (PPM) 植入是常见的,影响18.9%的患者. 虽然不增加死亡率,但PPM安置与更高的心力衰竭再入院率有关.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 医疗器械植入 医疗器械植入
背景情况:
- 在三膜手术 (TVS) 后,关于永久起器 (PPM) 植入的数据有限.
- 了解TVS后的PPM的发生率,风险因素和结果对于患者管理至关重要.
研究的目的:
- 评估TVS后PPM植入的发生率.
- 确定与TVS后的PPM安置相关的风险因素.
- 评估TVS后接受PPM的患者的结果,包括死亡率和再住院情况.
主要方法:
- 对2013年至2020年期间接受TVS的医疗保险受益人的回顾性分析.
- 排除了因内心炎接受TVS的患者.
- 对PPM植入的风险因素和结果的分析,如所有原因的死亡率和因内心炎或心力衰竭而重新住院.
主要成果:
- 在13,294名患者中,18.9%的患者在TVS后需要PPM安置.
- 风险因素包括女性性别,先前的胸骨切割,手术前的心脏阻塞,捆绑分支阻塞和先前的恶性瘤.
- 与修复相比,三门更换显著增加了PPM植入的风险 (RR, 3.20).
- PPM植入与死亡率的增加无关 (HR,1.02),但与心力衰竭再入院率的增加有关 (HR,1.28).
结论:
- 永久心脏起器植入是三管手术后经常发生的情况,特别是在女性患者和那些接受门置换的患者中.
- 虽然PPM植入并没有提高长期死亡率,但它与心力衰竭再住院的风险增加有关.
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