针对急性传染性内心炎的三膜手术可以在非常低的手术死亡率下进行
Ali Darehzereshki1, J Hunter Mehaffey1, J W Awori Hayanga1
1Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, WVa.
JTCVS open
|November 13, 2024
概括
对于内心炎的三膜手术显示了低的手术死亡率,如果可能的话,修复比更换更好. 这种成熟的外科手术方法仍然是主要的治疗选择.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 传染性疾病 传染性疾病
背景情况:
- 历史上,三门手术具有很高的风险,导致人们对透导管疗法产生了兴趣.
- 阿片类药物流行病增加了三管内心炎的发病率,特别是在注射毒品的人群中.
- 评估三膜手术的当代结果至关重要.
研究的目的:
- 为了评估三巴膜手术对内心炎的现实世界结果.
- 为了比较三门修复和更换之间的结果.
- 根据三膜内心炎的治疗选择,为临床决策提供信息.
主要方法:
- 对一个机构内心炎数据库 (2016-2021) 的分析.
- 包括因急性活性内心炎而接受单独或同时进行三管手术的患者.
- 临床结果的纵向随访.
主要成果:
- 283名患者接受了三角门修复 (48.4%) 或更换 (51.6%).
- 大多数患者是年轻人 (平均年龄31岁) 和活跃的注射药物使用者 (90.8%).
- 观察到低的手术死亡率 (1.8%整体,1.3%孤立) 和高的一年生存率 (89.3%整体,89.7%孤立). 与替换相比,三门修复的节拍器要求较低 (0%vs13.3%).
结论:
- 对于内心炎的三膜手术与低的手术死亡率有关.
- 在可行的情况下,三门的修复比更换更好.
- 三膜手术仍然是一个低风险的,除了抗生素之外,内心炎的第一线治疗选择.
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