科克斯迷宫IV和 mitra 门手术后永久起器的高发病率:一项基于国家注册的全国性研究
Torbjörn Ivert1, Gabriella Boano2,3, Farkas Vanky2,3
1Department of Cardiothoracic Surgery, Karolinska University Hospital and Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Interdisciplinary cardiovascular and thoracic surgery
|April 4, 2025
概括
接受Cox-maze IV (CMIV) 和关手术的患者面临永久心脏起器植入的长期风险更高. 节功能障碍是CMIV患者迟到需要起器的关键原因.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 电子生理学 电子生理学
背景情况:
- 心房动是一种常见的心律失常,通常用手术切除治疗.
- 密特拉手术经常用于膜心脏病.
- 考克斯迷宫IV手术是一种先进的手术切除技术.
研究的目的:
- 评估在Cox-maze IV (CMIV) 术后与中枢手术相结合的永久心脏起器植入的长期风险.
- 为了比较心脏起器植入率之间的CMIV和单独在患有心房动的患者中进行 mitra 门手术.
主要方法:
- 在全国范围内对397名接受CMIV和中枢门手术 (2009-2017年) 的患者进行了回顾性,基于注册表的分析.
- 与346名接受了没有切除的 mitra 门手术的患者进行比较 (2014-2017年).
- 后续行动延长至2022年9月30日.
主要成果:
- 在8年后,CMIV患者的心脏起器植入风险调整后翻了一番 (HR 1.96).
- 8年后心脏起器植入率在CMIV患者中为27%,对照组为13%.
- 心房静脉阻塞是早期心脏起器植入的主要原因,而鼻节功能障碍导致CMIV患者的植入迟到.
结论:
- 同时进行CMIV和中枢门手术与术后心脏起器植入率更高有关.
- 鼻节功能障碍是CMIV接受CMIV的患者晚期心脏起器植入的主要指示.
- 需要仔细考虑心脏起器的依赖性,对于接受CMIV与中枢手术的患者来说是有必要的.
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