重新干预急性大动脉假体内心炎:早期和中期结果
Michele D'Alonzo1,2, Yuthiline Chabry1,2, Giovanna Melica3
1Service de Chirurgie Cardiaque, DMU CARE, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, F-94010 Créteil, France.
Journal of clinical medicine
|January 8, 2025
概括
在大动脉置换后对急性传染性内心炎进行重复手术的早期死亡率很高,但提供了可接受的5年生存率. 这些复杂的假内心炎手术需要谨慎管理.
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:
- 需要更换大动脉的急性传染性内心炎带来了重大的手术挑战.
- 假内心炎的重复手术具有很高的风险,门内干预的选择有限.
- 手术管理往往涉及复杂的程序,增加了发病率和死亡率.
研究的目的:
- 分析急性传染性内心炎的手术重复手术的结果和挑战.
- 评估这些患者的早期和晚期死亡率,并发症以及主要心脏和脑血管不良事件 (MACCE).
主要方法:
- 追溯性,单心,观察性研究.
- 包括54名患者,他们在2016年至2023年期间因感染性内心炎接受了重新手术.
- 对终点的分析包括死亡率,并发症和MACCEs.
主要成果:
- 在63%的病例中,隔离性大动脉置换是可行的;在其他病例中,需要复杂的程序.
- 30天死亡率为18.5%,其中9.3%需要术后体外膜氧化 (ECMO) 和2.7%经历了新的中风.
- 五年整体生存率为58.3%,MACCEs的自由率为41.7%.
结论:
- 针对急性传染性内心炎的重复手术仍然是一个高风险的干预措施,具有显著的早期死亡率.
- 尽管存在风险,但5年生存率表明长期结果相对可接受.
- 通过手术治疗假内心炎是复杂的,需要专门的护理.
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