在退行性心肌外科手术期间同时进行三管修复的性别差异
Catherine M Wagner1, Whitney Fu2, Alexander A Brescia3
1National Clinician Scholars Program, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan; Department of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan.
The Annals of thoracic surgery
|April 14, 2024
概括
经过 mitra 门手术的三管吐 (TR) 妇女接受三管修复 (TVr) 的可能性较低. 这种基于性别的治疗差异导致女性重度TR和重复手术的比率更高.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 医学研究 医学研究
背景情况:
- 与男性相比,女性的三腹吐 (TR) 患病率更高.
- 已知三膜修复 (TVr) 可以缓解TR进展.
- 在米特拉手术期间执行TVr的潜在基于性别的差异需要调查.
研究的目的:
- 为了调查三门手术期间同时使用三门修复 (TVr) 的性别差异.
- 评估不进行TVr对严重TR的发展或需要门相关的重新手术的临床影响,按性别分层.
主要方法:
- 针对患有中度或更严重手术前TR (2014-2023) 的退行性疾病进行中枢门手术的成年患者的回顾性分析.
- 排除之前进行过三干预的患者.
- 多变量后勤回归以确定TVr的预测因子;竞争风险模型以比较没有TVr的患者的结果 (严重TR或重新手术).
主要成果:
- 研究队列包括388名患者,其中女性占55%.
- 女性在接受同期TVr (aOR,0.48;P = .006) 的调整后的几率显著降低,即使是严重的TR.
- 在没有接受TVr的患者中,12%的女性与0%的男性发生了严重的TR或在4年内需要重新手术 (P < .001).
结论:
- 在中度或重度TR患者中接受米特拉手术的女性,不太可能同时接受TVr.
- 这种差异与女性患重症TR并需要门相关的重新手术的可能性更高有关.
- 解决基于性别的治疗变异对于优化TR女性患者的治疗结果至关重要.
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