两大动脉关节相关动脉瘤的大动脉根替换后的长期结果
Kavya Rajesh1, Megan Chung1, Dov Levine1
1Division of Cardiothoracic and Vascular Surgery, Columbia University Medical Center, New York Presbyterian Hospital, New York, NY.
概括
接受双主动脉 (BAV) 的大动脉根置换的患者在15年内有35%的重复手术率. 然而,他们的长期存活率与美国普通人口相比,表明BAV修复后的良好结果.
科学领域:
- 心血管外科心血管外科
- 胸部外科手术 胸部外科手术
- 遗传性心脏病是一种先天性心脏病.
背景情况:
- 先天性双主动脉 (BAV) 是一种常见的疾病,由于动脉瘤的形成,往往需要更换主动脉根.
- 在BAV患者的大动脉根置换后,长期结果,包括死亡率和重新手术率,对于临床管理至关重要.
研究的目的:
- 为了评估长期死亡率和重复手术的患者双上大动脉谁经历了大动脉根置换.
- 在这个特定的患者队列中确定与长期死亡率相关的因素.
主要方法:
- 一项多中心的回顾性研究,涉及747名BAV患者,他们在2004年至2020年期间接受了大动脉根置换.
- 使用累积发病率曲线进行重复手术和卡普兰-梅尔生存分析,将队列与美国普通人口进行比较.
- 采用多变量考克斯回归来确定长期死亡率的预测因素.
主要成果:
- 该研究包括747名患者 (13.5%为女性),平均年龄为54岁. 常见的BAV功能障碍包括大动脉衰竭 (36.7%) 和狭窄 (25.0%).
- 住院死亡率很低 (1.3%). 在15年后,主动脉或主动脉复手术的累计发病率为35%.
- 生存率与年龄和性别匹配的美国人口相似. 死亡率增加与年龄较大,并发性冠状动脉旁路移植 (CABG) 和更长的旁路时间有关.
结论:
- 双主动脉患者的大动脉根置换与重复手术的显著率有关 (15年后为35%).
- 尽管有重复手术的几率,但这些患者的长期存活率与美国普通人口相当.
- 年龄,同时进行的CABG和绕道持续时间是影响主动脉根置换BAV患者长期死亡率的关键因素.
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