伴随性干预在关手术 - 一个欧洲的视角
Vinci Naruka1, Arian Arjomandi Rad2, Jacob Chacko1
1Department of Cardiothoracic Surgery, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK.
Perfusion
|March 2, 2024
概括
欧洲心脏外科医生在中枢手术中表现出多样化的实践,包括同时进行的手术和抗凝管理. 许多人偏离了既定的指导方针,突出了在中枢干预中需要标准化的方法.
科学领域:
- 心血管外科心血管外科
- 胸部外科手术 胸部外科手术
- 干预心脏病学 干预心脏病学
背景情况:
- 在并发手术和抗凝管理方面的近期进展显著影响了米特拉 (MV) 手术.
- 现有的文献表明,需要评估目前在MV干预方面的欧洲实践.
- 了解当代手术策略对于改善患者的治疗结果至关重要.
研究的目的:
- 评估欧洲各地中枢干预的现行实践.
- 为了确定手术技术和抗凝固管理的变化.
- 将当前的实践与既定的临床指南进行比较.
主要方法:
- 2021年10月,一项包含14个问题的在线调查被分发给欧洲各地的顾问/主治心脏外科医生.
- 通过电子搜索确定了国家心脏胸部协会,以促进调查的分发.
- 该调查侧重于并发手术,手术决策和MV手术的抗凝策略.
主要成果:
- 来自12个欧洲国家的91名外科医生参与了这项研究,其中78%的外科医生专门从事MV修复,大多数人每年进行150多次手术,具有丰富的经验.
- 在CABG期间管理同时发生的三腹吐和执行缺血性MV手术方面存在显著的变异性,干预的标准不同.
- 对心房动 (AF) 管理的实践,包括切除和左心房尾 (LAA) 封闭,以及对MV修复和生物假体门的抗凝策略显示出广泛的分歧.
结论:
- 目前在欧洲的中枢 (MV) 手术实践非常多样.
- 似乎缺乏对已确立的外科手术干预指南的一致遵守.
- 抗凝固策略也表现出显著的变化,这表明需要加强指导方针和标准化.
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