在类风湿性米特拉手术期间对中度大动脉功能障碍的态度:回顾性队列研究
Chuang Liu1, Maozhou Wang1, Peiyi Liu1
1Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Journal of thoracic disease
|February 20, 2025
概括
在类风湿性米特拉手术期间,对于中度的大动脉功能障碍,并发的大动脉手术改善了结果. 延迟大动脉治疗对于患有主导性大动脉吐的患者来说是安全的,定期进行后续检查.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 膜心脏疾病 膜心脏疾病
背景情况:
- 中度大动脉 (AV) 功能障碍在类风湿性 mitra (MV) 手术期间带来管理挑战.
- 这些患者同时进行AV手术的临床结果与不接受治疗的临床结果尚未确定.
研究的目的:
- 为了比较经过中度AV功能障碍的风湿性MV手术的患者的临床结果,随着或没有并发的AV手术.
主要方法:
- 一组343名患有风湿性MV手术和中度AV功能障碍的患者被跟踪了40个月的中位数.
- 主要终点:进展到轻度以上的静脉动脉功能障碍. 二级终点:所有原因的死亡率和心脏再手术.
主要成果:
- 患者被分为没有治疗 (NT,n=121) 和AV干预 (AVP/AVR,n=222) 组.
- 在加权后,NT组的初级终点率 (27.9% vs 8.0%,RR 2.98,P<0.001) 显著更高.
- 二次终点事件发生在5.0% (NT) 和7.3% (AVP/AVR) 的患者中.
结论:
- 同时的AV手术在风湿性MV手术患者中随访期间改善了AV条件,这些患者有中度的AV功能障碍.
- 延迟AV手术对于患有主导性中度大动脉吐的患者是安全的,前提是保持定期的随访.
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