在手术后的右心室缩功能的纵向变化,在接受单独的三腹吐手术的患者
Megumi Hirokawa1, Masao Daimon2, Koki Nakanishi1
1Department of Cardiovascular Medicine, the University of Tokyo Hospital, Tokyo, Japan.
概括
在三管 (TV) 手术后的右心室 (RV) 功能障碍对于严重的孤立三管反 (TR) 可以影响结果. 这项研究发现,手术后RV功能下降,但手术前RV末缩面积与身体表面积的索引可以预测保留的功能.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
背景情况:
- 右心室 (RV) 功能障碍是三管 (TV) 手术后的一种已知的并发症,用于严重的孤立三管吐 (TR).
- 虽然术后RV功能障碍与不良结果有关,但TV手术前后RV功能的纵向变化尚未得到充分证实.
- 了解这些变化对于患者管理和预测手术成功至关重要.
研究的目的:
- 为了研究三管 (TV) 手术后右心室 (RV) 缩功能在患有严重孤立三管吐 (TR) 患者的纵向变化.
- 为了确定在术后期保存RV缩功能的预测因素.
主要方法:
- 对24名因单独的严重TR而接受电视手术的患者的回顾性分析.
- 在基线和手术后1个月和4-20个月测量RV分数面积变化 (RVFAC).
- 在维护和减少术后RV功能的患者之间,RVFAC和RV末缩面积与人体表面积 (RVESA/BSA) 索引的RVFAC和RV末缩面积比较.
主要成果:
- 手术后立即显著减少RVFAC,并在后期随访时保持下降 (分别p < 0.001和p = 0.002).
- 50%的患者 (12/24) 在手术后晚期保留了VR系统功能.
- 在手术前的RVESA/BSA在患有维护术后RV功能的患者中显著较低 (p = 0.001),预测的最佳切线为10.8cm2/m2 (AUC,0.85).
结论:
- 对于严重的单独TR而言,三巴手术会导致RV缩功能显著且持续下降.
- 手术前的RV末缩区域与身体表面积的指数是手术后保留RV功能的有价值预测指标.
- 这些发现可以帮助患者选择和TV手术的风险分层.
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