在双和三动脉患者中,隔离性动脉置换后上升性动脉进展
Hua-Jie Zheng1, Xin Liu1, San-Jiu Yu1
1Department of Cardiac Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, People's Republic of China.
Brazilian journal of cardiovascular surgery
|July 22, 2024
概括
在隔离性主动脉置换后,双主动脉 (BAV) 和三主动脉 (TAV) 的患者中,长期存活率和主动脉不良事件相似. 在这些患者中,BAV不是主动脉不良事件的危险因素.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 大动脉疾病 大动脉疾病
背景情况:
- 双动脉 (BAV) 是一种常见的先天性心脏缺陷.
- 上升的大动脉扩张是BAV患者已知的并发症.
- 三主动脉 (TAV) 作为一个对比主动脉病理.
研究的目的:
- 为了比较上升大动脉扩张和大动脉不良事件的长期结果.
- 为了评估接受隔离性大动脉置换的BAV和TAV患者之间的差异.
- 为了确定BAV是否是主动脉不良事件的独立风险因素.
主要方法:
- 对310名接受隔离性大动脉置换 (2010-2021) 的患者进行了回顾性研究.
- 患者分为BAV (n=90) 和TAV (n=220) 组.
- 对上升的大动脉扩张率和长期大动脉不良事件的分析.
主要成果:
- 10年整体存活率相似 (89%的BAV与75%的TAV,P=0.343调整后).
- 年平均上升性大动脉生长率相似 (0.5毫米/年BAV与0.4毫米/年TAV,P=0.498).
- 在这两组中,10年内无发生主动脉不良事件的比例很高 (98.1%的BAV与95.0%的TAV,P=0.636). 手术前的上升大动脉直径预测了不良事件 (HR 1.76,P<0.001).
结论:
- 隔离性大动脉置换后的BAV和TAV患者的长期存活率和大动脉不良事件的风险相似.
- 双主动脉在这个队列中没有被确定为主动脉不良事件的独立风险因素.
- 上升的大动脉直径是大动脉不良事件的重要预测因素.
相关概念视频
Mitral Regurgitation I: Introduction
Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
Aortic Regurgitation I: Introduction
IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
Aortic Regurgitation II: Clinical Features and Diagnostic Tests
Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
Aortic Regurgitation III: Medical Management
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
Aortic Regurgitation IV: Nursing Management
A nurse managing a patient with aortic regurgitation begins with a comprehensive assessment, including a review of the patient's medical history, family history, and lifestyle factors. During the cardiac examination, the nurse listens for heart sounds and checks for signs of valve abnormalities. The nurse also observes for symptoms such as dyspnea, orthopnea, and paroxysmal nocturnal dyspnea and assesses the patient's endurance and daily activity tolerance.Based on the findings, the nurse...
Aneurysm II: Clinical Manifestations and Diagnostic Studies
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...


