透气管肺替换和手术肺替换的结果:一个队列分析
Kritvikrom Durongpisitkul1, Ekkachai Dangrungroj2, Paweena Chungsomprasong1
1Division of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand.
概括
透气管肺置换 (TPVR) 与手术肺置换 (SPVR) 相比,提供了更好的结果,包括较低的死亡率和更短的住院时间. TPVR可以实现更大的植入物,使患者在Fallote修复四重症后受益.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 医疗器械 医疗器械
背景情况:
- 费洛修复的四重症往往需要随后的肺门更换.
- 透气管肺置换 (TPVR) 已经成为外科手术肺置换 (SPVR) 的一个不那么侵入性的替代方案.
研究的目的:
- 在需要肺置换的患者中比较TPVR和SPVR的临床结果和程序特征.
- 评估TPVR与SPVR在现实环境中的有效性和安全性.
主要方法:
- 在2010年至2021年期间接受肺置换的215名患者的回顾性评估.
- 在TPVR (n=72) 和SPVR (n=143) 组之间比较患者人口统计,程序细节和临床结果.
- 平均随访时间为2年.
主要成果:
- TPVR患者接受了较大的肺植入物 (中位数为29.0毫米与24.0毫米).
- TPVR组的死亡率显著降低 (0 vs. 8例死亡),严重并发症减少,住院时间缩短 (P < .001).
- 两年后,TPVR与QRS持续时间的更大减少有关 (5 ms与1 ms相比,P = .006).
结论:
- 与SPVR相比,TPVR与优异的结局有关,包括降低死亡率和发病率.
- TPVR促进了更大的门植入,可能导致更好的长期结果.
- 对于具有非常大的本源右心室外流通道 (>30毫米) 或需要同时进行外科手术的患者,SPVR可能仍然是一个合适的选择.
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