大动脉手术后结构化后续成像的实用性
Megan M Chung1, Annie Yu1, Yanling Zhao2
1Division of Cardiothoracic and Vascular Surgery, NewYork-Presbyterian Hospital, Columbia University Irving Medical Center, New York, NY.
The Journal of thoracic and cardiovascular surgery
|February 11, 2024
概括
大动脉手术后的结构化后续成像显示了低的合规性,但增加了重新干预率. 无症状成像经常显示出临床相关的发现,突出显示了持续监测的必要性.
科学领域:
- 心血管外科心血管外科
- 医疗成像医学成像
- 健康 结果 研究 研究 结果
背景情况:
- 大动脉手术后的术后随访是指导方针建议的,但其临床实用性尚不清楚.
- 通过大动脉程序进行结构化后续成像被假设可以改善患者的治疗结果.
- 无症状手术后成像的放射性发现被记录下来.
研究的目的:
- 评估开放胸前大动脉手术后结构化后续成像的临床实用性.
- 为了比较有和没有预定成像随访的患者之间的结果.
- 在例行术后成像中描述放射性发现.
主要方法:
- 对接受开放胸前大动脉手术的患者 (2017年1月至2021年7月) 的回顾性分析,不包括内心炎.
- 在有计划成像和没有计划成像的患者之间比较生存 (Kaplan-Meier) 和重新干预 (细灰子危险函数).
- 对主动脉生长,伪动脉瘤和周移植密度的常规成像检查的审查.
主要成果:
- 在手术后3年,随访遵守率为38.6%.
- 随访患者的再干预率较高 (26.0%vs9.0%),但4年后的存活率 (98.7%vs95.2%) 类似.
- 伪动脉瘤,显著的周周移植密度,或增长≥3毫米/年发生在49.7%的病例中.
结论:
- 结构化后续成像实施表明临床合规性较低.
- 随访与大动脉再干预率的增加有关.
- 临床相关的放射性发现是常见的,并且在5年内增加,而不是早期停滞.
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