中心在与重复手术中心替换在没有成功的中心生物假体患者中
Abdullah Al-Abcha1, Yehia Saleh2,3, Safi U Khan2
1Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.
概括
透气管中膜 (MViV) 替换显示较低的住院死亡率相比重复手术中膜替换 (Redo-SMVR). 中期随访结果相似,MViV显示大出血风险降低.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 心脏外科手术 心脏外科手术
背景情况:
- 透气管中膜 (MViV) 替换是高风险患者的替代方案,其中包括膜生物假体失败.
- 对这些患者来说,重复手术中膜置换 (Redo-SMVR) 是传统的治疗方法.
研究的目的:
- 为了比较MViV替代与重复SMVR的结果,在患有生物假体中膜失败的患者中.
- 评估死亡率,出血,中风,血管并发症和门梯度的差异.
主要方法:
- 一个研究水平的七项观察性研究的元分析.
- 包括5083名患者 (MViV组1138人) 没有成功的 mitra bioprostheses.
- 主要终点是全因死亡率;次要终点包括出血,中风和门梯度.
主要成果:
- 替代MViV的患者在医院内死亡率明显降低 (OR,0.64;P = .0023).
- 大型出血风险与MViV (OR,0.23;P = .01) 相比显著降低.
- 短期,一年期和中期随访的死亡率在各组之间没有显著差异.
结论:
- 与重复SMVR相比,MViV替代与较低的住院死亡率有关.
- 替代MViV可显著减少主要出血事件.
- 在各种随访间隔中没有观察到死亡率的显著差异.
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