机械与生物双置换:从倾向性得分对生存率和重新操作率的匹配中获得的见解
Nina Feirer1, Anna Buchner1, Melanie Weber1
1Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, School of Medicine & Health, Technical University of Munich, Munich, Germany.
The Journal of thoracic and cardiovascular surgery
|July 27, 2024
概括
对于有症状的中枢门疾病,机械门置换提供了与生物门相比的生存率,但在20年内,重复操作率明显较低. 这有助于在抗凝血和重新操作风险之间做出选择.
科学领域:
- 心血管外科心血管外科
- 生物材料科学 生物材料科学
- 临床结果研究研究
背景情况:
- 手术中关节置换是对症状性中关节疾病的可行的治疗方法,当修复是不可行的.
- 在生物和机械门假肢之间的选择涉及平衡抗凝风险与重新操作的必要性.
研究的目的:
- 为了比较机械关置换 (MMVR) 和生物关置换 (BMVR) 之间的长期存活率和重新操作率.
- 提供证据,以指导临床决策在中枢置换手术.
主要方法:
- 一个单一中心的回顾性研究,对2027名从2001年至2020年接受米特拉置换的患者进行了研究.
- 倾向性得分匹配被用来创建可比较的组进行分析.
- 在平均6.83年的随访期内,分析了生存率和重复手术的累积发病率.
主要成果:
- 在倾向得分匹配后,对339对接受MMVR和BMVR的患者进行了比较.
- 两组在20年内表现出相似的生存率 (P = .203).
- 与20年后的BMVR相比,MMVR的复手累积发病率明显较低 (15%对59%,P<.001).
结论:
- 在高体积中心的长期随访表明,机械和生物中枢替换的生存率类似.
- 机械门更换与重复操作率相对较低有关.
- 这些发现支持在重复手术是一个重大问题患者的机械门.
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