在三管操作后,与永久心脏起器放置相关的因素
Salman Zaheer1, Sari D Holmes1, Emily Rodriguez1
1Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
The Annals of thoracic surgery
|October 19, 2024
概括
在三巴手术后,15%的患者需要永久心脏起器 (PPM) 植入. 三椎置换和缺乏经验的外科医生增加了PPM风险,突出了改善外科手术技术的必要性.
科学领域:
- 心血管外科心血管外科
- 心脏电生理学 心脏电生理学
背景情况:
- 导电异常需要永久心脏起器 (PPM) 植入是常见的三角门手术后,具有不同的发病率.
- 在三手术后,PPM的当代发病率和风险因素需要调查.
研究的目的:
- 调查三门手术后永久心脏起器 (PPM) 植入的当代比率.
- 为了确定与PPM植入后三手术相关的风险因素.
主要方法:
- 对胸腔外科医生协会成人心脏手术数据库 (2011-2020) 的分析.
- 包括接受三管修复或更换的患者.
- 多变量逻辑回归以检查与手术后PPM风险相关的因素.
主要成果:
- 71,937名患者中有15%需要PPM植入三手术后.
- 三椎置换 (比修复高3.2倍的风险),并发手术,更长的绕道时间和更低的外科医生/医院体积增加了PPM风险.
- 孤立的三管修复有4%的PPM率,而孤立的替换有24%的率.
结论:
- 在全国范围内,接受三手术的患者中有15%需要PPM植入.
- 增加的PPM风险与同时进行的手术,三骨置换,更长的心肺绕道和经验较少的外科医生/中心有关.
- 创新是必要的,以减少这一显著的发病率.
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