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肺置换 - - A ACHD患者10年的单中心手术经验

Armin Darius Peivandi¹, Sven Martens¹, Anaïs Gion¹

¹Department of Cardiothoracic Surgery, University Hospital Muenster, Muenster, Germany.

|October 4, 2024

概括

在患有先天性心脏病 (ACHD) 的成年人中,手术肺置换 (sPVR) 是一个安全的选择. 这项研究表明sPVR提供了低风险和良好的结果,使其适合未来的门内门程序.

科学领域:

心脏病学心脏病学
心脏外科手术心脏外科手术
成年人的先天性心脏病

背景情况:

在接受重复手术的患有先天性心脏病 (ACHD) 的成年人中进行手术肺置换 (sPVR) 的大规模结果数据很少.
了解ACHD中sPVR的结果对于管理复杂的心脏疾病至关重要.
标准化手术方法对于在重复心脏手术中获得一致的结果至关重要.

研究的目的:

为了分析十多年来在ACHD患者中sPVR的外科结果.
在 ACHD 中展示 sPVR 的标准化手术方法.
通过心声学和MRI评估手术前和手术后的心脏功能.

主要方法:

在2013年1月至2022年8月期间接受sPVR的79名ACHD患者的回顾性分析.
包括初级诊断,外科手术期间的数据,心声学和RV MRI.
使用配对测试比较手术前和手术后的MRI参数;Shapiro-Wilk测试的正常性.

主要成果:

79名患者 (59.5%是男性,平均年龄为41.7岁) 接受了sPVR,其中89.9%是重复手术,主要是因Fallot四重律 (59.5%).
术后心声图显示没有中度/严重的缺陷;MRI显示显著降低索引RV-EDV和RV-ESV.
住院死亡率为5.1%;57%同时接受手术,31.6%接受了心跳手术.

结论:

手术肺置换 (sPVR) 是需要重复手术的ACHD患者的安全治疗选择.
该程序带来了低的手术风险和令人满意的术后结果,包括改善RV功能.
sPVR为那些可能需要未来的门内干预的患者提供了一个可行的选择.

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