轻度或中度形大动脉病的管理,在患者接受手术的亚大动脉阻塞的患者
Tedy Sawma1, Hartzell V Schaff1, Steve R Ommen2
1Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota.
The Annals of thoracic surgery
|December 6, 2024
概括
大动脉脱提供了与大动脉替换相似的结果,用于轻度至中度的形大动脉狭窄症,在为左心室外流通道阻塞而进行肌切除术的患者中.
科学领域:
- 心血管外科心血管外科
- 心脏外科手术 心脏外科手术
- 成年人的先天性心脏病
背景情况:
- 轻度至中度的性大动脉狭窄 (AS) 可能会使下大动脉左心室外流通道 (LVOT) 阻塞的手术治疗复杂化.
- 通过脱或替换进行大动脉 (AV) 干预,对接受过关节隔膜切除术的患者进行评估.
研究的目的:
- 评估AV脱与AV替代的短期和长期结果,在患有轻度至中度性AS的患者中,为下静脉LVOT阻塞进行肌切除术.
主要方法:
- 分析了一组由93名患者组成的队列,这些患者在轻度至中度的AS (2000-2023) 中接受了AV干预的肌肉切除术.
- 患者被分为AV脱 (n=44) 和AV替代 (n=49) 组.
- 为了进行比较,包括了44名没有接受AV干预的患者的对照组.
主要成果:
- 静脉动脉脱和替换产生了类似的早期血液动力学改善和可比的长期生存率.
- 脱和替代组之间的AV再干预率相似,比对照组低.
- 在脱组中没有发生严重的AV反.
结论:
- 大动脉脱是一种可行的选择,适用于轻度至中度的性AS,用于为LVOT阻塞而接受肌切除术的患者.
- 以化程度为指导的手术管理提供了良好的早期结果和与静脉静脉置换相比的晚期结果.
- 与没有AV干预相比,AV脱和替换都显示出有利的结果.
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