温和的缺血性腹回,排气小部分<40%,在重血管化期间同时接受腹修复:单中心观察性研究
Ye Yang1, Fangyu Liu1, Yulin Wang1
1Department of Cardiovascular Surgery, Zhongshan Hospital Fudan University, 200032 Shanghai, China.
Reviews in cardiovascular medicine
|July 30, 2024
概括
患有中度缺血额头吐 (IMR) 和左心室 (LV) 功能抑郁 (EF < 40%) 的患者与具有更好的LV功能 (EF ≥ 40%) 的患者相比,经历了类似的手术死亡率和中期结果. 然而,在手术后,他们更可能需要长时间的通风.
科学领域:
- 心血管外科心血管外科
- 心脏外科手术的结果
- 中心门维修 维修中心门
背景情况:
- 适度的缺血性 mitrale regurgitation (IMR) 通常与冠状动脉疾病同时发生.
- 在重血管化过程中修复心交膜是IMR的常见治疗方法.
- 抑郁的左心室 (LV) 功能对IMR手术结果的影响还未得到充分研究.
研究的目的:
- 评估在中度IMR患者的重血管化过程中对美特拉修复的短期和中期结果.
- 评估 LV 功能减弱 (EF < 40%) 对该患者队列手术结果的影响.
主要方法:
- 对272名中度IMR患者进行了回顾性观察性研究,这些患者正在接受米特拉修复和再血管化.
- 根据射出分数 (EF) 分组患者:<40% (n=90) 和≥40% (n=182).
- 结果比较之前和之后的倾向性得分匹配,随访时间中位数为42个月.
主要成果:
- 在EF组之间手术死亡率没有显著差异 (8.9%与3.3%,p=0.076).
- EF<40%的患者心率较低 (8.9%对2.7%,p=0.034) 和呼吸时间较长 (13.3%对5.5%,p=0.026).
- 在倾向性得分匹配后,EF<40%独立预测了长时间通风,但没有预测手术死亡率或其他主要疾病;存活率相似.
结论:
- 在接受修复和再血管化的中度IMR患者中,抑郁的LV功能 (EF<40%) 与延长的通风增加有关.
- 在这组患者中,手术和中期死亡率不会受到 LV 功能衰退的显著影响.
- 在重血管化过程中对中度IMR进行中心门修复似乎是安全和有效的,无论LV功能如何.
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