双体和三体门疾病的外科动脉置换:在>1100名患者中的7年结果
Louis Labrousse1, Michael G Moront2, Francois Dagenais3
1Medico-Surgical Department of Valvulopathies, Bordeaux Heart University Hospital, Bordeaux-Pessac, France. louis.labrousse@chu-bordeaux.fr.
概括
通过使用Avalus生物假体进行大动脉置换手术显示,双管大动脉患者的7年治疗结果非常出色. 这种程序显示出有利的结果,包括类似的血液动力学性能和低的重新干预率与三管相比.
科学领域:
- 心血管外科心血管外科
- 生物假体门的使用方法
- 大动脉膜疾病 大动脉膜疾病
背景情况:
- 双动脉 (BAV) 影响0.5-2%的人口,经常出现在年轻,较低风险的个体中.
- 对于BAV患者的最佳主动脉置换 (AVR) 策略存在不确定性.
- 在这个人群中评估较新的生物假体对于明智的临床决策至关重要.
研究的目的:
- 为了比较使用Avalus生物假体的外科AVR (SAVR) 的7年临床结果,在患有先天性双门与三门的大动脉的患者中.
- 评估Avalus生物假体在不同大动脉形态上的性能和安全性.
主要方法:
- 一项前性非随机研究包括1132名患者,他们用Avalus生物假体接受了SAVR.
- 患者被分为两管 (n=339) 和三管 (n=775) 大动脉组.
- 用Kaplan-Meier分析和多变量Cox模型与倾向得分调整来评估7年的结果.
主要成果:
- 在7年后,双骨队列的死亡率较低 (8.9%vs21.3%),但与三骨队列相比,非结构性门功能障碍较高 (2.9%vs0.6%).
- 血液动力学参数,包括有效孔面积和平均大动脉梯度,在各组之间是相似的.
- 重复干预率在双 (6.8%) 和三 (5.4%) 队列中都很低,并且在双 (6.8%) 和三 (5.4%) 队列中都相当.
结论:
- 带有Avalus生物假体的SAVR为双管和三管主动脉患者提供了出色的7年结果.
- 生物假体表现出类似的血液动力学性能和低的重新干预率跨门形态.
- 这些发现支持Avalus生物假体作为AVR在双主动脉患者的安全和有效选择.
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