对于心房膜和心房结构的微创心脏手术中Iatrogenic主动脉剖析†
Sebastian Johannes Bauer1,2, Yukiharu Sugimura1,2, Friederike Irmgard Schoettler2
1Department of Cardiac Surgery, Medical Faculty and University Hospital, Heinrich-Heine-University, Dusseldorf, Germany.
概括
最少侵入性心脏手术很少导致大动脉剖析,但当它发生时,结果很差. 术前成像和术后监测对于患者的安全和改善结果至关重要.
科学领域:
- 心血管外科心血管外科
- 胸部外科手术 胸部外科手术
- 血管外科 血管外科
背景情况:
- 最少侵入性心脏手术 (MICS) 为传统的中枢骨切除提供了一个替代方案.
- 人们担心,MICS.的急性大动脉解剖 (IAAD) 风险增加.
- 有限的证据涉及手术前诊断,以减少IAAD的风险和手术内管理.
研究的目的:
- 评估在接受MICS的患者中IAAD的发生率和结果.
- 确定与IAAD相关的风险因素和患者个人资料.
- 描述在MICS期间管理IAAD的最佳周术策略.
主要方法:
- 对1065名患者进行了回顾性,单中心的观察性研究.
- 患者通过右侧前侧胸切除术与大腿管管道进行MICS.
- 评估IAAD发生率,患者人口统计和主要不良心血管事件 (MACE).
主要成果:
- 在8名患者中发生了IAAD (0.75%),其中50%在心肺绕道启动时被确定.
- 观察到37.5%的住院死亡率和12.5%的非致命性中风率.
- 在患有大动脉化或敌对的外周动脉的患者中,手术前CT扫描被遗漏.
结论:
- IAAD是一种罕见但严重的MICS并发症.
- 术前成像和手术规划对于降低风险至关重要.
- 早期的手术内诊断和量身定制的手术适应可以提高安全性和结果.
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