结合压力和体积负荷用于左心室训练在患有先天纠正大动脉转移的患者

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Antonia Schulz^1,2,3,4, Marcus Kelm^2,4,5, Viktoria H M Weixler^1,2,3,4

¹Department of Congenital and Pediatric Heart Surgery, Deutsches Herzzentrum der Charité, Berlin, Germany.

JTCVS open

|November 13, 2024

概括

在患有大动脉先天纠正转移的患者中,左心室训练显著增加了左心室质量和压力. 然而,老年患者的反应有限,这影响了双开关操作的适用性.

科学领域:

心脏病学心脏病学
儿科心脏手术儿科心脏手术
遗传性心脏病是一种先天性心脏病.

背景情况:

大动脉的先天纠正转移 (ccTGA) 通常需要在双开关操作 (DSO) 之前进行左心室 (LV) 训练.
在这些复杂的儿科病例中,评估联合压力和体积负荷的有效性对于优化LV训练策略至关重要.

研究的目的:

评估联合压力和体积负荷对接受LV训练的ccTGA患者左心室改造的影响.
确定影响LV培训反应的因素,以及随后对双开关操作的资格.

主要方法:

一项回顾性研究分析了15名ccTGA患者,他们在2012年至2022年期间接受了LV培训.
肺动脉训练涉及肺动脉带带,在大多数情况下,心房切除术,使用联合压力和体积负荷.

主要成果:

LV 训练导致 LV 质量指数 (21 至 38.5 g/m2,P=.002) 和静脉 LV/RV 压力比率 (0.35 至 0.94,P=.002) 显著增加.
43%的患者符合DSO的资格标准,其中5人接受了手术. 年龄较大的患者表现出 LV 压力增加的减少.
两名老年患者被确定为不响应者,仍然不适合DSO.

结论:

压力和体积负荷的组合有效地促进了儿科ccTGA患者的LV重塑.
年龄是LV培训响应的一个因素,老年患者可能是LV培训和DSO资格的非响应者.

关键词:

在 PAB PAB PAB 里面.ccTGAGA 在线观看加强了LV培训的LV培训.l-TGAGA 是一个TGA.左心室的训练是左心室的训练.肺动脉动脉带肺动脉动脉带

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