在澳大利亚进行心房动手术:我们做得够好了吗?
Frazer Kirk1, Matthew S Yong2, Lavinia Tran3
1Department of Cardiothoracic Surgery, Gold Coast University Hospital, Gold Coast, Qld, Australia; School of Medicine and Dentistry, Griffith University, Gold Coast, Qld, Australia; College of Medicine and Dentistry, James Cook University, Townsville, Qld, Australia.
Heart, lung & circulation
|October 4, 2024
概括
心房动 (AF) 影响澳大利亚和新西兰14%的心脏手术患者,比以前认为的更高. 尽管有证据表明AF的好处,但AF的手术治疗方法,包括切除和绑定,仍被严重不足利用.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 电子生理学 电子生理学
背景情况:
- 心房动 (AF) 是接受心脏手术的患者常见的并发症.
- 了解这个人群中AF的当代负担和治疗对于遵守指南和改善患者结果至关重要.
研究的目的:
- 检查澳大利亚和新西兰接受心脏手术的患者心房动 (AF) 的当前患病率和治疗趋势.
- 将当代实践与心脏手术期间AF手术管理的既定指南进行比较.
主要方法:
- 澳大利亚和新西兰心脏和胸部外科医生协会国家心脏手术数据库的十年回顾分析 (2011-2021年).
- 包括所有成人心脏手术患者,根据AF的存在或不存在进行分组.
- 描述性统计分析以评估人口统计,并发症,按手术类型划分AF发生率,以及手术AF治疗趋势 (绑定,切除或组合).
主要成果:
- 该研究确定了140,680名心脏手术患者,14% (21,077名患者) 患有AF,比之前报告的发病率更高.
- 患有AF的患者年龄较大,女性更频繁,并且具有较高的NYHA呼吸障碍分类和较低的射出分数.
- 在中枢门手术和CABG-门联合手术中,AF发生率更高. 只有11.90%的AF患者使用了切除和绑定等外科治疗方法,其中Cox-Maze IV切除的患者数量为19.54%.
结论:
- 澳大利亚和新西兰心脏手术患者同时出现心房的患病率高于之前的估计.
- 尽管有强烈的建议和经过证明的好处,但AF的手术干预,包括左心房附带绑定和切除,在这个患者队列中显著不足.
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