mitra 门手术在经过过导管干预以进行 mitra 吐后失败:手术技术,挑战和结果
Mateo Marin-Cuartas1, Syed Zaid2, Jörg Kempfert3,4,5
1University Department of Cardiac Surgery, Leipzig Heart Center, Leipzig, Germany.
概括
过导管边缘到边缘修复失败后的手术 mitra 门手术是复杂的,具有高风险. 为了获得更好的结果,建议将患者转移到大量的中心.
科学领域:
- 心血管外科心血管外科
- 干预心脏病学 干预心脏病学
背景情况:
- 越来越多地使用的是对位管过导管边缘到边缘修复 (M-TEER).
- 由于M-TEER的失败,需要进行外科手术,这带来了独特的挑战.
研究的目的:
- 对M-TEER失败的外科手术方法进行审查.
- 讨论运营挑战,决策和结果.
- 要突出设备移除和复杂解剖学的技术考虑.
主要方法:
- 综合文献综述. 这是一个全面的文献综述.
- 分析来自经验丰富的M-TEER失败手术治疗的高体积中心的数据.
主要成果:
- 在多达6%的患者中发生M-TEER衰竭,通常在6个月内发生.
- 在M-TEER后进行手术的死亡率高 (30天:10-40%) 和1年生存率低 (<60%).
- 常见的故障机制包括设备问题,疾病进展和内心炎;修复率很低 (<10%).
结论:
- 对M-TEER失败的手术在技术上具有挑战性,因为改变了解剖学,并发病症和需要同时进行手术.
- 尽管存在风险,但手术干预可以从 mitrale 吐中获得持久的缓解.
- 转介到大量的中枢门中心对于最佳管理至关重要.
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