透导管与小儿大动脉狭窄的手术干预之间的比较:日本的一项多中心研究
Jun Muneuchi1, Ayako Kuraoka2, Yusaku Nagatomo3
1Department of Pediatrics, Kyushu Hospital, Japan Community Healthcare Organization, 1-8-1, Kishinoura, Yahatanishi-Ku, Kitakyushu, Fukuoka, 806-8501, Japan. jmune@msn.com.
Heart and vessels
|May 4, 2024
概括
对于儿科的大动脉狭窄,气球大动脉膜整形 (BAV) 和手术大动脉膜整形 (SAV) 显示了类似的长期存活率和重新干预率. 这项研究比较了接受VAS的BAV或SAV的儿童的结果.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 干预心脏病学 干预心脏病学
- 遗传性心脏病是一种先天性心脏病.
背景情况:
- 儿童的大动脉狭窄症 (vAS) 在初步干预方面存在治疗困境.
- 过导管气球大动脉膜整形 (BAV) 和外科大动脉膜整形 (SAV) 是主要的治疗选择.
- 在儿科VAS中比较BAV和SAV的结果需要进一步调查.
研究的目的:
- 为了比较跨导管气球大动脉膜整形 (BAV) 与手术大动脉膜整形 (SAV) 在患有隔离大动脉狭窄症 (vAS) 的儿科患者的长期结果.
- 分析BAV和SAV组之间生存率,重新干预的需要和门置换率的差异.
- 确定影响免于重新干预和门更换的因素.
主要方法:
- 一个多中心的回顾性病例控制研究,涉及73名儿童 (<15岁) 患有静脉血管系统,来自4个三级先天性心脏中心.
- 在BAV和SAV群体之间比较10年生存率,再干预和假肢/自移植门更换率.
- 进行了倾向性得分匹配分析,以控制混变量.
主要成果:
- 在BAV和SAV组之间,在10年生存率 (BAV:88%与SAV:92%),再干预率 (BAV:58%与SAV:31%) 或门置换 (BAV:21%与SAV:19%) 中没有发现显著差异.
- 不需要重新干预与大动脉环z分数相关 (HR 0.66,P=0.005).
- 没有门置换与干预后大动脉吐相关 (HR 4.58,P=0.027).
- 倾向性得分匹配分析 (N=16) 证实生存率或再干预率没有显著差异.
结论:
- 无论是BAV还是SAV,都为儿科静脉血管系统提供了可接受的长期存活率.
- 在BAV和SAV之间,无需重新干预和门更换的免费率是可比的.
- 大动脉环的大小和大动脉反的程度是影响长期结果的重要因素.
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