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发生率,风险因素和与大动脉根置换后永久心脏起器植入相关的长期结果
Sameer K Singh1, Dov Levine1, Elizabeth L Norton2
1Division of Cardiothoracic and Vascular Surgery, Department of Surgery, Columbia University Irving Medical Center, New York, NY.
The Journal of thoracic and cardiovascular surgery
|July 22, 2024
概括
在大动脉根置换 (ARR) 后永久心脏起器植入 (PPI) 不常见,发生在3.8%的患者中. 虽然与更长的住院时间有关,但ARR后的PPI不会增加死亡风险.
科学领域:
- 心血管外科心血管外科
- 心脏电生理学 心脏电生理学
背景情况:
- 在主动脉置换 (AVR) 后,永久心脏起器植入 (PPI) 与不良的长期结果有关.
- 对PPI发生率和大动脉根置换 (ARR) 后的结果的数据有限.
研究的目的:
- 确定PPI在ARR后的发病率,风险因素和长期结果.
- 为了比较ARR后的PPI和无PPI患者的结果.
主要方法:
- 在2005年至2020年期间,对2240名接受ARR的患者进行了回顾性分析.
- 排除标准包括内心炎,A型解剖或手术前的PPI.
- 评估了PPI和长期存活率的独立风险因素.
主要成果:
- PPI的发病率为3.8% (n=85),最常见的是完全心脏阻塞.
- 独立的PPI预测因素包括双主动脉,女性性别,手术前的心脏阻塞和之前的AVR.
- 预防PPI的保护因素包括手术前的大动脉衰竭和门节约性根部置换.
- PPI与手术后或长期死亡率的增加无关,但导致了更长的住院时间.
结论:
- 在ARR后的PPI很少见,特别是在门节约手术后.
- 手术前的导电问题,先前的AVR和双主动脉增加了PPI风险.
- 虽然PPI会延长住院时间,但它不会影响ARR后的早期或晚期死亡率.
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