成年人大动脉修复:不同门修复技术的长期临床结果和心声学演变
Francesco Zito1,2, Kevin M Veen1, Giovanni Melina2
1Department of Cardiothoracic Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands.
概括
大动脉修复/节约技术为大动脉回和动脉瘤提供有效的长期治疗,恢复预期寿命,具有良好的血液动力学结果. 这些门节约手术表明重新干预的风险是可以接受的,这使得它们成为符合条件的患者可行的选择.
科学领域:
- 心血管外科心血管外科
- 心脏外科手术的结果
- 大动脉膜疾病 大动脉膜疾病
背景情况:
- 大动脉修复/节约技术是大动脉吐和动脉瘤的已知治疗方法.
- 长期耐用性,可重复性和患者选择仍然是关键问题.
- 对这些程序来说,评估长期的临床和心声学结果至关重要.
研究的目的:
- 评估大动脉修复/节约技术的长期临床和心声学结果.
- 专注于大动脉反度和左心室喷射率的演变.
- 为了比较不同大动脉门修复/节约技术的结果.
主要方法:
- 包括从心脏门协会大动脉数据库中接受大动脉门修复/节省的成年患者.
- 时间到事件分析和混合效应模型被用于结果评估.
- 分析了四种技术:隔离门修复,上升大动脉更换+门修复,部分根部更换和门节约根部更换.
主要成果:
- 在所有组中,十年生存率与一般人群相似.
- 经过10年的累计再干预发生率因技术而异,从8.5%到19.5%不等.
- 严重的手术前大动脉反和增加左心室终端透析直径预测了门节约根置换中的重新干预;贴片使用在所有组中都是预测因素. 左心室喷射分数最初有所改善,然后稳定.
结论:
- 大动脉的修复/节约技术是可行的和有效的治疗选择.
- 这些手术应考虑在符合条件的患有大动脉吐和/或大动脉动脉瘤的患者.
- 这些技术有可能恢复预期寿命和良好的血液动力学结果,并具有可接受的再干预率.
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