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动脉切换手术后的第五个十年,用于大动脉的转移

Sebastiaan W H van Wijk¹, Maaike Wulfse¹, Mieke M P Driessen²

¹Department of Pediatric Cardiology, Wilhelmina Children's Hospital, Utrecht, the Netherlands.

International journal of cardiology. Congenital heart disease

|December 23, 2024

概括

大动脉转移 (TGA) 的动脉切换手术 (ASO) 的长期幸存者表现出良好的功能类,但早期的患者需要更多的重新干预,并且心室功能下降.

科学领域:

儿童心脏病学儿童心脏病学
生产性心脏手术手术生产心脏手术
心脏外科手术的结果

背景情况:

自1977年以来,动脉切换手术 (ASO) 已成为大动脉转移 (TGA) 的标准手术治疗方法.
本研究研究了长期结果,重点关注 ASO 治疗的 TGA 患者的死亡率,发病率,心室功能和重新干预.

研究的目的:

为了比较1991年之前和之后接受ASO的患者之间的长期死亡率和发病率.
为了评估晚期心室功能和TGA的ASO的成年幸存者的再干预率.

主要方法:

一项对283名接受TGAASO治疗的患者进行的回顾性队列研究.
根据手术年份 (1991年之前或之后) 将患者分成两组,并对患者进行长达34.8年的随访.
分析了临床数据和心声回声学发现.

主要成果:

在较晚的队列中,早期的存活率显著改善 (96.6%与67.8%相比).
晚期死亡率很低 (1.8%),并且在各组之间相似.
早些时候接受手术的患者 (A组) 每次随访时间需要更多的重新干预,随着时间的推移,人们转向了以导管为基础的手术.
虽然大多数患者处于NYHA I类,但早期的队列显示左心室平均射出分数 (LVEF) 减少.

结论:

大多数患者在ASO后的十年内仍然处于良好的功能类.
手术结果有所改善,在较新的队列中,死亡率和重新手术率有所降低.
长期监测是有必要的,因为左心室功能下降的趋势,以及早期患者群体需要晚期的大动脉置换.

关键词:

大动脉门的大动脉门动脉开关操作 (ASO) 动脉开关操作心声回声扫描 (Echocardiography) 是一种心声回声扫描.后续行动后续行动长期的长期的长期的大动脉的转移 (TGA)

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