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永久性心脏起器植入和患者的长期结果同时进行 mitra 和三巴手术
Alexander Iribarne1, Sundos H Alabbadi2, Alan J Moskowitz3
1Department of Cardiothoracic Surgery, Staten Island University Hospital, Northwell Health, Staten Island, New York, USA.
Journal of the American College of Cardiology
|April 24, 2024
概括
将三管解体术 (TA) 添加到 mitra 修复 (MVr) 中,增加了永久心脏起器 (PPM) 植入的风险. 在MVR或MVR与TA后的PPM植入与较高的死亡率,心力衰竭住院和内心炎有关.
科学领域:
- 心血管外科心血管外科
- 心脏电生理学 心脏电生理学
- 医疗器械产生的结果
背景情况:
- 在关修复 (MVr) 期间的三管解体术 (TA) 可能会增加对永久起器 (PPMs) 的需求.
- 在MVR与TA后的PPM植入后的确切风险和长期影响尚不清楚.
研究的目的:
- 为了确定隔离后的MVR与TA的MVR之间的PPM植入率.
- 在这些患者群体中评估与PPM植入相关的长期临床结果.
主要方法:
- 对纽约和加利福尼亚州医院出院数据 (2004-2019) 的分析.
- 患者接受孤立MVr与MVR与TA的比较,通过90天内PPM植入进行分层.
- 倾向性得分权重用于比较生存率,心力衰竭住院,内心炎,中风和重新手术.
主要成果:
- 包括32,736名患者:28003人分离MVR,4733人MVR + TA.
- 90天的PPM率为MVR的7.7%,MVR+TA的14.0%.
- PPM与生存率降低有关 (MVR的HR为1.96,MVR + TA的HR为1.65),心力衰竭住院次增加 (HR为1.56) 和内心炎 (HR为1.95).
结论:
- 在MVr期间同时服用TA显著增加了90天PPM植入的风险.
- 在MVr后的PPM植入 (有或没有TA) 与更糟糕的长期结果有关,包括死亡率,心力衰竭住院和内心炎.
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