在老年患者中,在伴随着主动脉替换的中枢手术中程序选择策略和临床结果
Kazuma Handa1, Toshihiro Ohata1, Naosumi Sekiya1
1Department of Cardiovascular Surgery, Sakurabashi Watanabe Hospital, 2-4-32 Umeda, Kita-Ku, Osaka, 530-0001 Japan.
Indian journal of thoracic and cardiovascular surgery
|February 23, 2024
概括
对于接受双门手术的老年患者,与大动脉门置换一起进行合性门修复或更换的量身定制方法可以改善长期的存活率和门耐用性. 这一策略为联合的大动脉和中枢门疾病提供了更好的结果.
科学领域:
- 心血管外科心血管外科
- 老年心脏病学 老年心脏病学
- 膜心脏疾病 膜心脏疾病
背景情况:
- 接受双门手术的老年患者 (大动脉和 mitra) 缺乏对 mitra 门修复 (MVP) 和更换 (MVR) 的明确标准.
- 在手术上更换大动脉 (SAVR) 期间优化对关膜疾病的管理对于改善高风险老年患者的治疗结果至关重要.
研究的目的:
- 为了研究门的耐用性和生存率,使用特定的手术策略对老年患者的中枢门疾病进行治疗,同时接受SAVR.
- 为老年患者在SAVR期间确定选择中膜整形 (MVP) 或中膜置换 (MVR) 的标准.
主要方法:
- 在2010-2022年间接受双门手术 (心心门手术+SAVR) 的86名患者 (65岁以上) 的回顾性评估.
- 手术策略:简单病例的MVP (n=47),复杂病例的MVR (n=39).
主要成果:
- 医院死亡率为8%.
- 10年生存率为62%,其中95%无需主动脉重新操作.
- 没有需要进行额头膜再干预;在10年内,86%的人没有中度额头气.
结论:
- 在老年高风险患者中,适当选择与SAVR配合的额头门手术 (MVP或MVR) 可以改善早期和长期的生存率.
- 这种手术策略表明了良好的门耐用性,并可能有利于老年患者与结合的大动脉和中枢门疾病.
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