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动脉起器植入后对主动脉内心炎手术的影响:一项全国性的研究†
Lisa O F Bearpark1, Michael Dismorr1,2, Anders Franco-Cereceda1,2
1Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
概括
在大动脉内心炎手术后植入心脏起器是常见的. 这项研究在接受起器的患者中没有发现死亡,心力衰竭或再感染的风险增加,这表明手术没有受到威胁.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 传染性疾病 传染性疾病
背景情况:
- 传染性内心炎 (IE) 构成心房阻塞的重大风险.
- 对IE的手术增加了需要永久起器的可能性.
- 在IE患者中植入心脏起器的长期影响仍未得到充分研究.
研究的目的:
- 分析长期临床结果的患者接受了永久的起器在大动脉IE手术后.
- 评估心脏起器植入与死亡率,心力衰竭和假体膜再感染之间的关联.
主要方法:
- 瑞典全国观测队列研究 (1997-2022年).
- 包括接受大动脉手术的患者IE.
- 使用治疗权重的逆概率和灵活的参数模型.
- 评估结果:全因死亡率,心力衰竭和假体膜再感染.
主要成果:
- 8% (168/2175) 的患者在手术后30天内接受了永久性起器.
- 在心脏起器植入与增加死亡风险 (HR 1.17),心力衰竭 (HR 1.42) 或再感染 (HR 0.85) 之间没有发现显著的关联.
- 15年后,累计死亡率为60%的起器,而没有起器的死亡率为50%;心力衰竭为21%和16%.
结论:
- 在主动脉IE手术后植入心脏起器是很常见的.
- 心脏起器的使用与死亡,心力衰竭或再感染等不良长期结果无关.
- 需要心脏起器,虽然表明更严重的疾病,但不会影响挽救生命的IE手术的成功.
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