跨时代的三门更换:实践模式和结果
Catherine M Wagner1, Leah Schoel2, Whitney Fu2
1Department of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan.
The Annals of thoracic surgery
|April 11, 2025
概括
手术三门置换 (TVR) 的结果显著改善. 主要发病率和死亡率下降,而中期存活率近年来增加.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 医学成果研究研究成果
背景情况:
- 三门替换 (TVR) 从历史上来看具有很高的风险.
- 关于TVR外科手术前期结果的当前数据有限.
- 这项研究调查了TVR结果随着时间的推移的趋势.
研究的目的:
- 为了评估手术三巴置换后主要发病率和手术死亡率的变化.
- 评估三巴置换后中期存活率的趋势.
- 为了确定TVR的结果是否在近年来有所改善.
主要方法:
- 从2000年到2023年进行手术TVR的250名成年患者的回顾性审查.
- 患者被分为三个阶段:2000-2013,2014-2019年和2020-2023年.
- 主要结局是主要发病率和手术死亡率的复合;使用多变量逻辑回归和卡普兰-梅尔分析.
主要成果:
- 主要发病率和手术死亡率的综合结果在不同时期显著下降 (48%至21%),主要是由于长时间通风减少.
- 经风险调整后的结果显示,类似的显著下降 (44%至21%).
- 中期 (18个月) 存活率从最早时期的63%大幅提高到最近时期的82%.
结论:
- 近年来,手术三巴置换的结果显著改善.
- 主要的发病率和死亡率显著下降.
- 在TVR之后的中期存活率显示出显著的上升趋势.
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