在接受同时进行大动脉置换的患者中,中枢修复与替换
Yi Zhang1, Guangguo Fu1, Gang Li1
1Department of Cardiac Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Heart, lung & circulation
|November 29, 2024
概括
大动脉置换加上心心修复 (AVR加MVR) 提供了比双置换 (DVR) 更好的长期生存和更少的并发症. 然而,风湿性心脏病患者可能需要使用AVR加MVr的更高的重新手术率.
科学领域:
- 心血管外科心血管外科
- 心脏门疾病 心脏门疾病
- 进行元分析分析.
背景情况:
- mitra 门修复 (MVr) 通常在孤立的 mitra 门疾病中比 mitra 门更换 (MVR) 产生更好的长期结果.
- 对于患有主动脉和中枢结合疾病的患者进行MVr的益处仍在争论中.
研究的目的:
- 为了比较主动脉置换 (AVR) 加MVR与双置换 (DVR) 的生存益处.
- 评估早期死亡率,重新手术率和门相关的不良事件.
主要方法:
- 一项比较AVR加MVR与DVR的研究的元分析.
- 在PubMed,EMBASE和Cochrane数据库的文献搜索到2022年10月.
- 主要结局:长期存活;次要结局:早期死亡率, mitrale reoperation,门事件.
主要成果:
- AVR加MVR显示出更好的长期生存趋势 (80.95%在5年 vs 76.62%的DVR).
- AVR加MVR显著降低了早期死亡率,血栓栓塞和出血事件.
- 观察到可以比较的 mitrale reoperation 和传染性内心炎的比率,除了风湿性心脏病患者的更高的 reoperation.
结论:
- 与未被选择的患者的DVR相比,AVR加MVR与有利的长期存活率和减少不良事件有关.
- 这种手术不会增加额头肌再手术或感染性内心炎的风险一般.
- 经过AVR加MVr的风湿性心脏病患者经历了显著更高的重新手术率.
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