格伦和Fontan之间的全身静脉附带:患病率,治疗和对结果的影响
Michelle Bao Hoa Nguyen Cong1, Thibault Schaeffer1, Takuya Osawa1
1Department of Congenital and Pediatric Heart Surgery, German Heart Center Munich, Technische Universität München, Division of Congenital and Pediatric Heart Surgery, University Hospital of Munich, Ludwig-Maximilians-Universität München, Europäisches Kinderherzzentrum München, Munich, Germany.
Cardiology in the young
|January 30, 2025
概括
双向腔肺突变和全腔肺连接之间的静脉 - 静脉附带发生在12.3%的患者中. 这些附带因素可能是由高压和先前的手术引起的,在全腔肺连接后不会影响长期生存.
科学领域:
- 心血管外科心血管外科
- 儿童心脏病学 儿童心脏病学
- 遗传性心脏病是一种先天性心脏病.
背景情况:
- 阶段性全腔肺连接 (TCPC) 是复杂先天性心脏病的常见手术方法.
- 静脉静脉附带体 (VVCs) 可以在双向腔肺突变 (BCPS) 和TCPC之间形成,可能会影响血液动力学.
- 了解VVC的发病率,风险因素和临床影响对于优化患者管理至关重要.
研究的目的:
- 评估在经历了阶段性全腔肺连接 (TCPC) 的患者中静脉附带病 (VVC) 的患病率.
- 确定与VVCs发展相关的风险因素.
- 为了确定VVCs对TCPC后临床结果的影响.
主要方法:
- 在1995年至2022年期间接受了分阶段TCPC的586名患者的回顾性评估.
- 血管图学评估以描绘和分析BCPS和TCPC之间的VVC.
- 统计分析以确定患病率,风险因素和结果相关性.
主要成果:
- 在12.3%的患者 (72/586) 中发现了静脉静脉附带体 (VVCs).
- 较高的BCPS前肺动脉压力和跨肺梯度,以及更先前的息手术与VVC的发展有关.
- 在TCPC前,肺动脉压力和心室末端透气压力升高,VVC患者的动脉氧和率较低.
- 在5.5%的患者中进行了VVC干预;然而,VVCs在TCPC后没有显著影响10年生存率 (92.8%对92.7%).
结论:
- 在BCPS和TCPC之间,VVC的流行率为12.3%.
- 升高的肺动脉压力,跨肺梯度和之前的息手术是VVC发展的危险因素.
- VVCs似乎不会对TCPC后的临床结果或存活率产生不利影响.
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