在感染性内心炎中修复三管
Veronica Lorenz1, Stefano Mastrobuoni1, Gaby Aphram1
1Department of Cardiothoracic and Vascular Surgery, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Interdisciplinary cardiovascular and thoracic surgery
|April 30, 2024
概括
三膜内心炎 (TVE) 修复是有效的,特别是在年轻的患者中. 一种以修复为导向的方法,有或没有心周贴片,提供了良好的长期存活率和无需重新手术的自由.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 传染性疾病 传染性疾病
背景情况:
- 越来越多地使用可植入设备和血管接入有助于右侧传染性内心炎.
- 三膜内心炎 (TVE) 是一个日益关注的问题,特别是在患有先天性心脏病的患者和需要透析的患者中.
- 目前的指导方针有利于三管门的修复,但在实践中门更换仍然很常见.
研究的目的:
- 分析使用原生三膜内心炎 (TVE) 修复方法的临床经验.
- 评估TVE患者的三门修复与更换的结果.
- 评估TVE治疗后的长期存活率和重新操作率.
主要方法:
- 一系列31名患者的病例,他们在2001年至2020年期间接受了急性或治愈的原生三膜内心炎 (TVE) 手术.
- 患者根据手术方法进行分类:三巴修复 (n=28) 或更换 (n=3).
- 基于使用心周贴片的修复结果的子组分析.
主要成果:
- 在90.3%的患者中进行了三门修复,只有9.7%的患者接受了门置换.
- 与替代组 (33.3%) 相比,修复组 (7.1%) 的医院死亡率较低.
- 十年整体存活率为75.6%,在10年内无需重新手术的情况为补丁修复的59.3%,非补丁修复的93.7%. 在10年内,无复发性内心炎的比例为87%.
结论:
- 以修复为导向的策略应该是三膜内心炎 (TVE) 的首要选择,特别是在年轻患者中.
- 用心周贴片是严重损坏的门的一个可行的选择.
- 当修复是不可行的时,合体同移植替代作为一种有价值的替代方案,最大限度地减少了假肢材料的使用.
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