耳前关闭与术后心房动的风险增加有关
Jeffrey H Shuhaiber1, Mostafa Abbas2, Thomas Morland2,3
1Massachusetts General Hospital, Wellman Institute, Thier Bldg. Suite 204 A, 50 Blossom St, Boston, MA, 02114, USA. Jeffrey.Shuhaiber@gmail.com.
Journal of cardiothoracic surgery
|November 3, 2024
概括
在心脏手术患者中,没有先前的AF的左心房尾关闭 (LAAC) 会增加术后心房动 (POAF) 的风险. 然而,LAAC并没有显著影响死亡率,中风或再入院率.
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:
- 手术后心房动 (POAF) 是心脏手术后的一个常见并发症.
- 左心房尾关闭 (LAAC) 越来越多地使用,但其对特定手术群体的POAF的影响尚不清楚.
研究的目的:
- 在没有手术前心房动 (AF) 的心脏手术患者中研究LAAC和新发性POAF之间的关联.
- 评估LAAC对其他关键术后结果的影响.
主要方法:
- 从STS数据库 (2018-2021) 中对2059名心脏手术患者 (CABG,AVR,MVR) 的回顾性分析.
- 169名患者接受了LAAC;倾向性得分匹配创建了一个1:1队列 (162对).
- 主要结局:新发性POAF;次要结局:1年死亡率,30天再入院,1年中风和LOS.
主要成果:
- LAAC与新发性POAF的发生率显著增加相关 (41.4%与25.3%,p=0.003).
- 接受LAAC治疗的患者在术后住院时间 (LOS) 较长 (142.1 vs 120.5小时,p=0.001).
- 两组之间1年死亡率,30天再入院或1年中风发生率没有显著差异.
结论:
- 在心脏手术患者中,没有先前的AF,LAAC与POAF率的增加有关.
- 在一年内,LAAC并没有对主要不良事件 (如中风或死亡率) 产生显著影响.
- 需要进一步的研究来澄清LAAC在这个患者队列中的风险益处概况.
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