骨干门修复对生存,再干预和左心室功能的影响
Mimi Xiaoming Deng1,2, Conall Morgan3,4, Kyle Runeckles5
1Division of Cardiovascular Surgery, Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Ontario, Canada.
Annals of thoracic surgery short reports
|January 10, 2025
概括
新生儿常见动脉干 (CAT) 的修复与中度至严重的干反 (TVR2-3) 需要更多的重新干预,并具有更高的早期死亡率. 然而,渐进的左心室扩张被很好地容忍.
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
- 心脏门维修 心脏门维修
背景情况:
- 骨干缺陷 (TVI) 是一种已知的死亡风险因素,用于新生儿常见动脉干 (CAT) 的初级修复.
- 了解TVI在CAT修复中的长期结果对于手术规划和患者管理至关重要.
研究的目的:
- 为了比较初级常见动脉干 (CAT) 修复的结果,新生儿中度至严重的干回 (TVR2-3) 与那些没有或轻度回 (TVR0-1).
- 评估TVI严重程度对存活率,再干预率和CAT修复后左心室重塑的影响.
主要方法:
- 这是一项追溯案例匹配的受控研究,涉及2000年至2018年期间接受初级CAT修复的32名新生儿.
- 根据手术标准,16名TVR2-3患者与16名TVR0-1患者进行匹配.
- 评估的结果包括生存率,骨干的重新干预率,残留的TVI,以及左心室 (LV) 的尺寸和功能.
主要成果:
- 在TVR2-3组,17年生存率为70%,在TVR0-1组为80% (P>.99).
- TVR2-3组的干再干预率显着更高 (5年后为67%,P = .005),并经历了更多的残留TVI.
- 在TVR2-3组3年后观察到显著的左心室扩张 (P = .001),但LV射出分数仍然可比.
结论:
- 接受初级CAT修复的中度至重度TVI的新生儿面临更大的干再干预负担和更高的早期死亡率.
- 尽管由于剩余的TVI导致LV逐渐扩大,但心室重塑被耐受良好,并没有显著影响LV喷射分数或临床状态.
相关概念视频
Mitral Valve Prolapse II: Assessment and Management
IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular tachycardia.
Mitral Regurgitation I: Introduction
Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
Mitral Regurgitation III: Medical Management
Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
Mitral Stenosis I: Introduction
Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
Mitral Stenosis III: Medical Management
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
Aortic Regurgitation III: Medical Management
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...


