在对双主动脉进行大动脉置换后的晚期大动脉手术
Kohei Hachiro1, Noriyuki Takashima2, Tomoaki Suzuki2
1Division of Cardiovascular Surgery, Department of Surgery, Shiga University of Medical Science, Setatsukinowa-cho, Otsu, 520-2192, Shiga, Japan. starplatinum.1140@gmail.com.
Journal of cardiothoracic surgery
|March 20, 2024
概括
双主动脉 (BAV) 患者在没有同时进行主动脉手术的情况下接受主动脉置换,以后主动脉手术的风险较低. 大动脉狭窄是这些患者晚期大动脉手术和整体死亡的预测因素.
科学领域:
- 心血管外科心血管外科
- 心脏外科手术的结果
- 双动脉膜疾病 双动脉膜疾病
背景情况:
- 双动脉 (BAV) 是一种常见的先天性心脏缺陷.
- 大动脉置换 (AVR) 是对症状性BAV的标准治疗方法.
- 针对BAV的隔离AVR后的长期结果需要进一步调查.
研究的目的:
- 评估BAV.患者中隔离AVR后的长期结果.
- 为了确定后期大动脉手术和整体死亡的风险因素.
- 评估隔离AVR在没有同时进行大动脉手术的BAV患者的安全性.
主要方法:
- 在2002年至2022年期间,对181名接受BAV隔离AVR的患者进行了回顾性分析.
- 平均随访时间为6.1年,完成率为97.8%.
- 竞争的风险回归模型 (Fine-Gray和Cox) 用于分析结果.
主要成果:
- 只有3名患者 (1.7%) 后来需要进行大动脉手术.
- 晚期大动脉手术的10年累计发病率为16.3%.
- 大动脉狭窄预测了以后的大动脉手术 (HR 8.477) 和整体死亡 (HR 8.270). 操作时间也预测了整体死亡 (HR 1.011).
结论:
- 在上升大动脉直径<45毫米的患者中,BAV的孤立AVR与随后的大动脉手术的低风险有关.
- 大动脉狭窄是发生大动脉不良事件和隔离AVR后死亡的重要危险因素.
- 仔细的患者选择和监测对于管理BAV至关重要.
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