50-70岁患者的组织与机械关置换:倾向匹配的分析
Nicholas M Fialka1, Abeline R Watkins2, Abrar Alam2
1Division of Cardiac Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada.
概括
对于年龄在50-70岁的患者,机械和生物假肢门置换 (MVR) 提供类似的长期存活率. 生物假体门增加了重复MVR的风险,而机械门不会增加中风风险.
科学领域:
- 心血管外科心血管外科
- 心脏门疾病 心脏门疾病
- 生物材料在医学中的应用
背景情况:
- 对于年龄在50-70岁的患者来说,最佳的关置换 (MVR) 选择仍在争论中.
- 机械与生物假肢MVR的长期结果需要进一步进行比较分析.
研究的目的:
- 在50-70岁的患者中,回顾性地比较机械和生物假体MVR之间的长期生存率和发病率.
- 评估这个患者队列中重复MVR,中风和其他并发症的风险.
主要方法:
- 对2004-2018年MVR数据的回顾性审查.
- 对286名患者 (143名机械,143名生物假体) 的倾向匹配分析.
- 主要结局:全因死亡率;次要结局:外科手术前和晚期发病率.
主要成果:
- 机械和生物假肢MVR之间在15.8年内所有原因死亡率没有显著差异.
- 机械MVR显示术后心房的发生率较低.
- 生物假体MVR的重复MVR率更高;中风或再入院没有显著差异.
结论:
- 在50-70岁的患者中,机械和生物假体MVR的长期存活率与机械和生物假体MVR相似.
- 生物假体MVR与由于结构的恶化而增加的重新操作风险有关.
- 门的选择需要仔细考虑重新手术,出血和血栓栓塞的风险.
相关概念视频
Mitral Valve Prolapse I: Introduction
1.1K
IntroductionThe mitral valve, one of the heart's four valves, regulates blood flow. These valves have flaps that open and close to direct blood properly through the heart and body. During each heartbeat, the flaps open for blood to pass through and seal shut to prevent backflow. Specifically, the mitral valve opens to allow blood flow from the heart's upper left chamber to the lower left chamber. It then closes securely as the lower left chamber contracts to pump blood to the body, preventing...
1.1K
Mitral Valve Prolapse II: Assessment and Management
1.4K
IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular...
1.4K
Mitral Regurgitation I: Introduction
1.3K
Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
1.3K
Mitral Regurgitation III: Medical Management
686
Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
686
Mitral Stenosis I: Introduction
1.8K
Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
1.8K
Mitral Stenosis III: Medical Management
535
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
535


