对于先天性关键大动脉狭窄的新生儿干预后的长期结果
Beatrice Bonello1, Richard Issitt1, Marina Hughes2
1Great Ormond Street Hospital, Great Ormond Street, London WC1N 3JH, UK; University College of London, Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
International journal of cardiology
|March 4, 2024
概括
临界大动脉狭窄症 (CAS) 患者的长期存活可以通过新生儿干预来实现,但通常需要重新干预,并可能导致持续的心肌功能障碍. 为了管理这些复杂的案件,全面的后续行动至关重要.
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:
- 关键性大动脉狭窄 (CAS) 是一种严重的先天性心脏缺陷,需要早期干预.
- 新生儿手术或导管手术是CAS的主要治疗方法.
- 了解干预后的长期结果和功能状态至关重要.
研究的目的:
- 评估CAS患者的长期生存和功能状态.
- 评估在CAS患者中是否需要重新干预.
- 在新生儿CAS干预的幸存者中描述心肌功能.
主要方法:
- 从1970年至2010年接受CAS干预的96名患者的回顾性审查.
- 在7岁以上的幸存者中进行临床评估和心肺运动测试.
- 先进的心声回声和心脏MRI用于心肌功能评估.
主要成果:
- 30年总生存率为68.5%,再干预率高 (32.9%).
- 55%的被评估的幸存者有受损的氧气吸收峰值.
- 观察到LV纵向应变的减少和辐射应变的增加,在5名患者中观察到EFE.
结论:
- 新生儿CAS干预提供了合理的长期生存,但需要频繁的重新干预.
- 在干预后仍然存在显著的长期临床和亚临床左心室心肌功能障碍.
- 详细的长期随访和心肌功能评估对于优化CAS患者管理至关重要.
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