在丹麦的Fontan手术后的30年生存期
Benjamin Kelly1, Maren Ravndal2, Anne Kathrine Møller Nielsen2
1Department of Cardiothoracic Surgery, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark. benjaminkelly@clin.au.dk.
Pediatric cardiology
|May 22, 2025
概括
在Fontan完成后,心脏病患者的30年生存率为87%. 近年来,结果有所改善,特别是对于那些没有低可塑性左心综合征 (HLHS) 的人来说,尽管随着年龄的增长,患病率会增加.
科学领域:
- 心脏病学 心脏病学
- 儿童心脏病学 儿童心脏病学
- 遗传性心脏病研究 遗传性心脏病研究
背景情况:
- 芬坦手术是复杂的先天性心脏缺陷的缓解手术.
- 在Fontan完成后的长期结果和发病率需要持续评估.
- 了解影响生存和临床表现的因素对于患者管理至关重要.
研究的目的:
- 评估丹麦患者在Fontan完成后的30年全国生存率.
- 评估手术时代,Fontan型和心室主导对生存的影响.
- 描述Fontan幸存者的临床表现和发病率.
主要方法:
- 对301名丹麦患者进行了复古的队列研究,这些患者接受了Fontan完成 (1977-2023年).
- 从外科注册和数字化健康记录中收集的数据,包括死亡率和发病率.
- 使用卡普兰-梅尔估计的生存分析;跨年龄组的病率比较.
主要成果:
- 在Fontan完成后的30年生存率为87%;免于死亡,移植或拆除是79%.
- 对于1997年以后的Fontan完成和非低可塑性左心综合征 (HLHS) 诊断的改善结果.
- 发病率 (例如,心室功能障碍,心律失常) 影响了38%的幸存者,随着年龄的增长而增加;运动能力随着年龄的增长而下降.
结论:
- 在Fontan完成后的长期存活率为87%,在最近的时代有显著的改善.
- 非HLHS患者和那些经过后期手术的患者显示出更高的生存率.
- 患病率普遍且与年龄相关,影响老年幸存者的生活质量和运动能力.
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