在年轻患者的罗斯手术A单中心,长期随访研究
Markus Liebrich1, Christoph Dingemann, Detlef Roser
1Department of Cardiac Surgery, Heart Center Stuttgart, Klinikum Stuttgart, Stuttgart, Germany; Institute for Clinical Epidemiology and Applied Biometrics, Medical University of Tübingen, Tübingen, Germany.
Deutsches Arzteblatt international
|October 8, 2024
概括
罗斯手术为年轻患者提供了优秀的长期存活率,这些患者需要更换大动脉. 这种手术选择显示了低的重复手术率和不良事件,使其成为对大动脉膜疾病的有效治疗方法.
科学领域:
- 心血管外科心血管外科
- 胸部外科手术 胸部外科手术
- 主动脉疾病管理
背景情况:
- 年轻患者的标准大动脉替换选择包括生物假体和机械.
- 罗斯手术,使用患者自己的肺来取代主动脉,是一种替代性的手术方法.
- 本研究评估了Ross手术在年轻患者队列中的长期结果.
研究的目的:
- 介绍年轻患者的罗斯手术与根部置换的长期结果.
- 评估整体存活率,再手术/再干预率和严重不良事件.
- 为了比较罗斯手术与标准大动脉置换手术在这个人口群体中的疗效.
主要方法:
- 在1995年至2020年期间,罗斯手术与根部置换手术对795名患者进行.
- 数据收集的重点是整体存活率,自移植和同移植/RV-PA管道再操作/再干预率以及不良事件.
- 随访完成率为96%,覆盖9540个患者年,平均随访时间为12±7年.
主要成果:
- 795名患者 (平均年龄为43±14岁) 接受了手术;30天死亡率为1%.
- 20年后的生存率为整体存活率的86%,自移植存活率没有重新手术的80%,同移植/RV-PA导管存活率没有重新手术的85%.
- 报告的出血率较低 (5),血栓栓塞并发症 (14),内心炎 (19).
结论:
- 罗斯手术的根部置换证明了高生存率超过25年.
- 这种手术与重新手术,重新干预,发病率,死亡率和内心炎的低率有关.
- 罗斯手术是对患有大动脉膜疾病的年轻患者的有效手术治疗方法.
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