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与永久心脏起器植入相关的长期结果在低风险的外科手术大动脉置换中

Ruixin Lu¹, Natalie Glaser^1,2, Ulrik Sartipy^1,3

¹Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.

|August 2, 2024

概括

在低风险患者手术上更换大动脉 (SAVR) 后永久心脏起器植入并没有增加死亡率,但确实增加了心力衰竭的发生率. 建议在SAVR后避免使用起器.

科学领域:

心脏病学心脏病学
心脏外科手术心脏外科手术
电子生理学电子生理学

背景情况:

手术性大动脉置换 (SAVR) 后的永久心脏起器植入与较高的死亡和心力衰竭风险有关.
了解心脏起器植入在接受SAVR的低风险患者的长期结果至关重要.

研究的目的:

评估在SAVR后接受永久起器的患者的长期预后,特别关注低风险个体.
确定永久心脏起器植入与该患者队列中关键不良事件之间的关联.

主要方法:

在瑞典进行的一项全国性基于人口的观察队列研究 (2001-2018) 包括接受SAVR的低风险患者 (后勤EuroSCORE I <10%或EuroSCORE II <4%).
在SAVR后30天内接受永久起器的患者与没有接受永久起器的患者进行了比较,分析了全因死亡率,心力衰竭住院和内心炎.
使用回归标准化来管理混因素.

主要成果:

该研究包括19,576名低风险患者,其中732名 (3.7%) 在SAVR后接受永久性起器.
在17年后,心脏起器和非心脏起器组之间没有观察到任何原因死亡率的显著差异.
在17年后,心脏衰竭的累积发病率在心脏起器组 (28%) 与非心脏起器组 (20%) 相比显著增加.

结论:

在SAVR后的低风险患者中,永久心脏起器植入与心力衰竭的发病率增加有关.
在这个队列中,心脏起器植入与全因死亡率或内心炎的增加没有相关性.
建议在SAVR后尽量减少对永久起器的需求,以改善患者的治疗结果.

关键词:

所有原因的死亡率.心内膜炎是一种心内膜炎.心力衰竭住院治疗住院治疗手术风险较低的手术风险很低.永久的心脏起器植入植入.

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