根据双向格伦程序对圆柱形缺陷的最终方法的比较
Yuze Liu1, Qiyu He1, Zheng Dou1
1Pediatric Cardiac Surgery Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Heart (British Cardiac Society)
|February 12, 2024
概括
双转换 (BiVC) 是双向格伦 (BDG) 息后复杂的干性心脏缺陷的Fontan完成的可行的替代方案. 这种策略为某些不适合Fontan完成的患者提供了可行的选择.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 遗传性心脏病是一种先天性心脏病.
- 心脏外科手术 心脏外科手术
背景情况:
- 复杂的干缺陷常见于分阶段的手术修复,通常涉及双向格伦 (BDG) 程序.
- 在BDG之后,Fontan完成或双心转换 (BiVC) 是最终的策略,最佳选择仍在讨论中.
- 干缺陷在儿科心脏外科手术中是一个重大挑战.
研究的目的:
- 为了比较Fontan完成与双心室转换 (BiVC) 的结果,在BDG息后患有干缺陷的儿科患者中.
- 评估死亡率和重新干预率作为主要和次要结局.
- 评估BiVC作为最终治疗策略的可行性和有效性.
主要方法:
- 在2013年至2022年期间接受BDG息治疗的患有干缺陷的儿科患者的回顾性分析.
- 排除单心室生理学的患者.
- 在Fontan和BiVC组之间比较住院结果,死亡率,再干预率和左心室大小.
主要成果:
- 在232名患者中,142人 (61.2%) 接受了Fontan完成,90人 (38.8%) 接受了BiVC.
- 与Fontan (3.62年) 相比,BiVC (4.15年) 的间期较长.
- 在医院的结果有利于Fontan完成;然而,手术后死亡率和重新干预率在各组之间是可比的. 在随访时,BiVC组的左心室尺寸更大.
结论:
- 双转换 (BiVC) 是一个可行的终极治疗选择,用于儿科患者,在BDG息后出现干缺陷.
- BiVC可能特别适合具有Fontan风险因素的患者或那些不适合Fontan完成的理想候选人.
- 虽然Fontan完成显示出更好的住院结果,但BiVC提供了一个可行的替代方案,在死亡率和重新干预方面具有可比的长期结果.
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