针对破坏性假体内心炎的同位移植大动脉根置换:当前时代的结果
Marco Pocar1,2,3, Cristina Barbero1,2, Matteo Marro1,2
1Division of Cardiac Surgery and Cardiothoracic Transplantation, Città della Salute e della Scienza, 10126 Turin, Italy.
Journal of clinical medicine
|August 10, 2024
概括
同体移植大动脉根置换为破坏性假内心炎提供了近90%的手术存活率. 亚斯巴酸氨酸酶 (AST) 水平和交叉时间预测结果,有助于对这种复杂的心脏手术的风险分层.
科学领域:
- 心血管外科心血管外科
- 传染性内心炎感染性内心炎
- 假肢的并发症 假肢的并发症
背景情况:
- 破坏性大动脉假内心炎具有显著的发病率和死亡率.
- 同人移植主动脉根置换是一种激进的,生物相容的手术选择,用于这种情况.
- 复杂的,高风险的手术通常需要为假内心炎.
研究的目的:
- 评估同位移植大动脉根置换在患有破坏性假肢内心炎的患者中的结果.
- 为了确定不良事件的预测因素,包括死亡率和重新操作,在此程序后.
- 评估在同位移植主动脉根替换后的长期生存和重新操作率.
主要方法:
- 自2010年以来,61名连续接受同移植主动脉根置换心脏再手术的患者的回顾性分析.
- 卡普兰-梅尔方法用于生存概率计算.
- 多变量回归分析以确定手术死亡,低心脏输出,功能衰竭和重复手术的预测因素.
主要成果:
- 操作死亡率为13%. 基线阿斯巴酸氨酸酶 (AST) 和部手术预测了手术死亡和低心力输出,分别.
- 低心率发生在20%的患者中. 估计3年生存率大约为70%.
- 较低的存活率与AST≥40 IU/L和大动脉十字时间≥180分钟有关. 五名患者需要重新手术.
结论:
- 对于破坏性假体内心炎的同种植大动脉根替代可以实现高的手术生存率 (近90%).
- 该程序显示了合理的三年死亡率和重新手术率.
- 在接受这种复杂手术的患者中,AST水平可能有助于分层化手术风险.
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