重复手术的大动脉根手术的早期结果是否受到之前的根手术和重新干预的指示的影响?
Haytham Elgharably1, Haley Jenkins1, Davut Cekmecelioglu1
1Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio.
JTCVS open
|May 1, 2025
概括
重置性大动脉根手术在技术上要求很高,但在经验丰富的中心提供低的手术死亡率. 假体移植和内心炎增加了术后并发症,但没有显著增加手术后死亡率.
科学领域:
- 心血管外科心血管外科
- 胸部外科手术 胸部外科手术
- 外科手术的结果
背景情况:
- 重置性大动脉根手术带来了重大的技术挑战.
- 之前的根部手术可能会影响患者的治疗结果.
- 了解影响早期结果的因素对于手术规划至关重要.
研究的目的:
- 评估先前的根部手术对重置性大动脉根部手术早期结果的影响.
- 评估手术指示对重置大动脉根手术早期结果的影响.
主要方法:
- 从2010年1月到2022年12月,对632名接受重复性大动脉根手术 (真正的重复根) 的患者进行了回顾性审查.
- 基线特征,手术细节和医院内并发症的比较,根据之前的根假肢类型和指示 (例如,传染性内心炎).
主要成果:
- 整体手术死亡率为2.2%,估计1,5年和10年生存率分别为93%,80%和67%.
- 在不同之前的假肢类型 (同位移植,本塔尔,自由式,门节约,罗斯) 中,手术死亡率相似.
- 涉及假肢移植 (本特尔,门节省) 的重新手术显示出更高的术后并发症率,包括因出血而重新手术,胸部关闭延迟和起器插入等.
- 与其他适应症相比,内心炎的患者有类似的手术死亡率,但在出血和长时间通风方面重新手术的几率较高.
结论:
- 在经验丰富的中心,重复性大动脉根手术可以在较低的手术死亡率下进行.
- 假体移植材料的扩张和内心炎与更复杂的术后过程有关.
- 这些并发症在重复大动脉根手术的背景下不会显著增加手术死亡率.
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