伴随性手术切除在宫性心房和持续性心房,在心肌外科手术期间
Ali Darehzereshki1, J Hunter Mehaffey1, J W Awori Hayanga1
1Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, West Virginia.
The Annals of thoracic surgery
|July 4, 2024
概括
在米特拉手术期间的手术切除和左心房附属物消灭 (SA+LAAO) 改善了心房动 (AF) 患者的长期结果. 与其他治疗方法相比,这种方法可以减少AF和心力衰竭的死亡率和再入院.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 医疗保健服务研究 医疗服务研究
背景情况:
- 尽管有证据支持并发治疗,但在心肌 (MV) 手术期间进行心房动 (AF) 的手术治疗有所不同.
- 这项研究评估了Medicare受益者在MV手术期间不同AF治疗的纵向结果.
研究的目的:
- 为了评估手术切除和左心房附属物抹除 (SA+LAAO) 与MV手术期间其他AF治疗的有效性.
- 为了比较结果,包括死亡率,中风,出血,AF和心力衰竭再入院.
主要方法:
- 对接受了AF的MV手术的医疗保险受益人的分析 (2018-2020年).
- 患者分为:没有AF治疗,单独进行左心房附属器消灭 (LAAO),或SA+LAAO.
- 两倍强大的风险调整和按AF类型 (持久性/阴性) 进行子组分析.
主要成果:
- 与没有AF治疗或仅使用LAAO相比,SA+LAAO与AF或心力衰竭的3年死亡率和再入院率降低有关.
- SA+LAAO显示,在3年内,中风或死亡的复合终点较低 (中风HR为0.75,死亡HR为0.83).
- 在患有持续性或性AF的患者中,SA+LAAO的益处是一致的.
结论:
- 在MV手术期间的SA + LAAO改善了与LAAO单独或没有AF治疗相比的纵向结果.
- 这些发现支持SA + LAAO作为在真实世界的数据中MV手术期间所有AF类型的有益策略.
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