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在当前时代的动脉开关手术后TGA的临床过程
Leo J Engele1,2, Roel L F van der Palen3, Renée S Joosen4
1Department of Cardiology, Center for Congenital Heart Disease Amsterdam-Leiden (CAHAL), Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
JACC. Advances
|June 28, 2024
概括
接受动脉切换手术以转移大动脉的患者的生存率很好. 然而,由于对干预的持续需求,终身监测至关重要,特别是在外流通道上.
科学领域:
- 心脏病学 心脏病学
- 儿童心脏病学 儿童心脏病学
- 生产性心脏病 手术 手术 生产性心脏病
背景情况:
- 接受动脉切换手术 (ASO) 进行大动脉转移 (TGA) 的患者人数正在增加.
- 关于当前时代的长期临床结果的数据有限.
研究的目的:
- 描述TGA-ASO患者全国队列中的晚期临床结果.
- 确定ASO后的生存率,再干预率和临床事件.
主要方法:
- 全国范围的前性注册包括1,061名TGA-ASO患者.
- 随访时间中位数为8.0年,分析使用年龄作为主要时间尺度.
- 计算了生存,再干预和临床事件的累积发病率.
主要成果:
- 在35岁的晚期生存率为93%.
- 到35岁时,累计的再干预率包括36%的右心室外流通道和16%的左心室外流通道.
- 临床事件发生在8%的患者中,重新干预的独立风险因素包括TGA亚型和肺动脉带状动脉.
结论:
- 用ASO治疗的大动脉转移患者表现出极好的生存率.
- 对终身再干预的重大需求,特别是在外流通道上,需要持续监测到成年期.
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