掌握大动脉门修复:一个标准化的逐步教学方法,用外环取消整形手术重塑根部置换
Gabriel Saiydoun1, Saade Saade2, Mohammed Alghamdi3
1Department of Cardiac and Thoracic Surgery, Pitié-Salpêtrière university Hospital, Sorbonne University, APHP, Paris, France; Department of cardiac surgery, Henri Mondor university hospital, APHP, Créteil, France.
概括
一种标准化的大动脉 (AV) 修复技术是可重复的,有效的学员在专家监督下学习. 这种方法可以提高全球成功的AV修复率.
科学领域:
- 心血管外科心血管外科
- 外科教育的外科教育
- 大动脉门维修
背景情况:
- 建议在大动脉动脉瘤时进行门节约性根部置换,但未得到充分利用.
- 限定的采用可能源于在标准化大动脉 (AV) 修复技术方面的挑战.
- 需要一种可重复的方法来提高全球AV维修率.
研究的目的:
- 评估标准化 AV 修复的可行性,可重复性和有效性.
- 为了比较专家外科医生和学习该技术的研究员之间的结果.
- 评估一种标准化方法的潜力,以提高AV维修的采用率.
主要方法:
- 从2013-2023年对653名患者进行前性队列研究.
- 由专家和受监督的研究员进行的标准化 AV 修复.
- 主要结局:死亡率,AV再干预,出血,复原和时间的复合.
主要成果:
- 在专家 (n=457) 和同学 (n=196) 组之间的初级结果没有显著差异 (HR,1.58;P=.07).
- 在两组中,五年内无需与AV相关的再干预率都很高 (97.0% 专家与99.50% 同学;P=.08).
- 住院死亡率,整体死亡率和并发症率在各组之间相似.
结论:
- 一个标准化的,逐步的 AV 修复与外部大动脉取消造形术是可重复的,有效的,可行的,安全的.
- 这种标准化技术的监督培训对于成功的学习至关重要.
- 推广这种方法可以提高其采用率,并提高全球AV维修率.
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