在管理前额叶叶片反的趋势
Sherif Khairallah1,2, Mohamed Rahouma1,2, Ivancarmine Gambardella1
1Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York.
JAMA network open
|April 15, 2024
概括
对前侧叶片病的米特拉修复略比对前侧叶片病的米特拉更换更常见. 许多关节置换发生在没有尝试修复的情况下,这表明人们不愿意进行这种手术.
科学领域:
- 心血管外科心血管外科
- 心脏门疾病 心脏门疾病
- 流行病学 流行病学
背景情况:
- 退行性心肌膜疾病是一种常见的疾病,需要手术干预.
- 对于孤立的前侧叶片病理,中枢置换 (MVR) 与中枢 (MV) 修复的患病率和趋势尚未得到充分确立.
- 了解这些趋势对于优化患者护理和手术策略至关重要.
研究的目的:
- 在美国调查MVR和MVR修复在患有孤立前额叶叶片退行性疾病的患者中的流行率和趋势.
- 分析接受MVR和MV修复的患者的特征.
- 检查随着时间的推移,手术方法和修复技术的变化.
主要方法:
- 一项采用胸腔外科医生协会成人心脏手术数据库的横截面研究.
- 鉴定2011年至2022年期间接受MVR或MV修复的孤立前额头叶片退行性反患者.
- 线性回归分析用于评估程序和技术的趋势.
主要成果:
- 分析了超过16000名患者,55.6%接受了MV修复,44.4%接受了MVR.
- 观察到MV维修的下降趋势 (58.0%至51.6%).
- MVR患者年龄较大,具有更多的并发症,MVR经常在没有尝试修复的情况下 (81.7%) 进行.
- 微创手术从5.0%增加到12.0%,而传统手术则下降.
- 新冠状病毒植入成为最常见的修复技术,随着时间的推移显著增加.
结论:
- mitra 门修复仍然是孤立的前叶片退行性疾病的稍微首选选择.
- 很大一部分MVR程序没有进行最初的修复尝试,这表明修复技术的潜在利用不足.
- 手术方法正在转向最少的侵入性方法,并且在修复策略中越来越喜欢neochordae植入.
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