动脉切换手术后肺动脉干预的发生率
Joshua D Kurtz1,2, Yana Feygin3, Samantha Stone4
1Department of Pediatrics, University of Louisville School of Medicine, Louisville, KY, USA.
概括
肺动脉干预在动脉切换手术 (ASO) 后常见,用于大动脉的转移. 较高体积的中心显示PA干预率较低,这表明经验改善了结果.
科学领域:
- 心脏病学 心脏病学
- 儿科手术 儿科手术
- 遗传性心脏病是一种先天性心脏病.
背景情况:
- 肺动脉 (PA) 狭窄是大动脉转移动脉切换手术 (ASO) 后的一种已知的并发症.
- 之前关于ASO后PA狭窄的报道仅限于小型的单中心研究.
研究的目的:
- 调查新生儿ASO后PA干预的发生率.
- 评估医院中心数量对大型国家队列中PA干预率的影响.
主要方法:
- 一项多中心的回顾性队列研究分析了从2005年到2021年接受新生儿ASO的婴儿,使用儿科健康信息系统数据库.
- 主要结局包括整体PA干预患病率和累积发病率,按中心体积第三层分层.
- 考克斯的比例危险模型评估了中心体积和干预率之间的关系,并考虑了中心的聚类.
主要成果:
- 在接受ASO的7411名婴儿中,1262名 (17%) 需要PA干预,中位时间为0.8年.
- 需要干预的婴儿最初住院时间较长,出生体重较低,并且更有可能出现心室隔膜缺陷.
- 与低和中等体积中心相比,PA干预的发生率在高体积中心明显较低 (HR分别为2.14和1.32).
结论:
- 在ASO后,PA干预是经常发生的,主要是在手术后的第一年内.
- 更大的手术中心与降低PA干预率有关,这表明专业护理的潜在好处.
- 需要进一步的研究来确定可修改的因素,这些因素可以降低ASO后的PA干预率.
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