接受完整血管环手术的患者的结果
Ajami Gikandi1, Peter Chiu1, Naomi Crilley1
1Harvard Medical School, Boston, Massachusetts, USA; Department of Cardiac Surgery, Boston Children's Hospital, Boston, Massachusetts, USA.
Journal of the American College of Cardiology
|September 25, 2024
概括
完整的血管环手术为儿童提供了优秀的症状缓解,并发症风险低. 在此程序后,由于持续的气消化系统问题而重新操作是不常见的.
科学领域:
- 儿科手术 儿科手术
- 心血管外科心血管外科
- 胸部外科手术 胸部外科手术
背景情况:
- 对于完整的血管环手术的综合结果数据有限.
- 血管环可以在儿童中引起显著的临床症状.
研究的目的:
- 详细介绍小儿病人的完整血管环修复的呈现,诊断,手术方法和结果.
- 评估完整血管环的手术干预的有效性和安全性.
主要方法:
- 对515名儿科患者 (1990-2023) 进行了回顾性队列研究,这些患者接受了针对完整血管环的初级或再手术手术.
- 术前评估包括CT血管造影,支气管镜和喉腔镜.
- 手术策略涉及全面的修复,包括切除Komerell分离体和在适当时进行气管切除术.
主要成果:
- 右主动脉与异常的左下关节动脉 (62.7%) 和双主动脉 (33.8%) 是最常见的.
- 没有术后死亡率;并发症包括胸 (5.4%) 和声带功能障碍 (4.3%).
- 随访时间中位数为3.0年,94.7%的患者实现了完全症状的消失;气消化系统症状的10年重复手术风险为9.6%.
结论:
- 完整的血管环手术在儿童中产生了较高的症状改善率.
- 这种手术的并发症风险很低,并且由于残留的气消化系统症状,不经常需要重新手术.
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