重新手术大动脉替换生物假体结构的恶化
Matthias Raschpichler1, Philip Kiefer1, Wolfgang Otto1
1Leipzig Heart Center, University Clinic of Cardiac Surgery, University of Leipzig, Leipzig, Germany.
概括
对于结构的恶化而进行的再手术大动脉置换 (rSAVR) 在考虑并发症时显示出与初级SAVR相似的结果. 可选的rSAVR提供与初始门置换手术相比的安全性和有效性.
科学领域:
- 心血管外科心血管外科
- 心脏门疾病 心脏门疾病
- 生物假体门的使用方法
背景情况:
- 结构损坏 (SVD) 是一个常见的并发症,需要重新操作.
- 与初级手术相比,重新手术大动脉置换 (rSAVR) 具有潜在的风险.
研究的目的:
- 为了比较初级生物假体外科大动脉置换 (SAVR) 与因SVD而孤立的rSAVR的结果.
- 确定风险因素并评估rSAVR的安全性.
主要方法:
- 来自接受初级SAVR和rSAVR (2011-2022) 的患者的临床数据的回顾性比较.
- 主要结局:在住院期间全因死亡率或中风.
- 二次结局:心肌梗塞,重新探索出血,心脏起器植入.
主要成果:
- 总共有2620名患者被分析;6.6%接受了rSAVR.
- 主要SAVR患者年龄较大,以前中风的病例较少.
- 单变量分析显示rSAVR的死亡率/中风率较高,但多变量分析和匹配的比较没有发现不良结果的显著差异.
结论:
- 最初的单变量分析表明rSAVR的风险更高,但伴随性疾病在很大程度上解释了这一点.
- 可选rSAVR可以达到与初级SAVR相比的结果.
- 患者的选择和并发症的管理对于成功的rSAVR至关重要.
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