最少侵入性和全胸切除动脉置换导致老年高风险患者的长期结果相似:一种倾向匹配的比较
Jan Hlavicka1, Larissa Gettwart1, Julian Landgraf1
1Department of Cardiovascular Surgery, University Hospital Frankfurt and Goethe University Frankfurt, 60596 Frankfurt/Main, Germany.
Journal of cardiovascular development and disease
|April 26, 2024
概括
在高风险的老年患者中,轻微侵入性大动脉置换 (MiniAVR) 与全胸腔切除术 (FS) 具有相似的短期和长期结果. 这项研究支持MiniAVR作为大动脉置换的标准手术.
科学领域:
- 心脏外科手术 心脏外科手术
- 最少侵入性手术的方法
- 大动脉门的更换
背景情况:
- 通过上部宫切除术进行最小侵入性大动脉置换 (MiniAVR) 是完全宫切除术 (FS) 的替代方案.
- 最少侵入性心脏手术为患者提供了好处.
- 这项研究比较了使用生物假肢的老年高风险患者中MiniAVR与FS的结果.
研究的目的:
- 通过FS比较MiniAVR与传统AVR的短期和长期结果.
- 为了评估存活率,重新手术率和内心炎发病率.
- 评估早期的主要心脏和脑血管不良事件 (MACCEs).
主要方法:
- 对441名用生物假肢进行隔离AVR的患者 (2006-2009) 的回顾性分析.
- 137名患者 (31.1%) 患有FS,304人 (68.9%) 患有MiniAVR.
- 倾向性得分匹配创造了两组68名患者进行比较;随访时间平均为7.6年.
主要成果:
- FS的心肺绕道和大动脉十字时间较短 (p<0.05).
- 30天死亡率相似 (两组均为2.9%).
- 在FS和MiniAVR组之间,长期存活 (1,5,10年) 和无重新手术/内心炎的情况是可比的 (p>0.05).
结论:
- 在具有生物假肢的高风险老年患者中,MiniAVR显示了与FS类似的短期和长期结果.
- 长期存活率,重复手术率和内心炎发病率是可比的.
- 建议将MiniAVR作为AVR的标准程序,即使在高风险人群中也是如此.
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