消除左心室出口狭窄症降低了内心纤维延伸症复发的风险†
Gregor Gierlinger1,2,3, Daniel Diaz-Gil1,4,5,6,7, Andreas Tulzer3,8
1Department of Cardiac Surgery, Boston Children's Hospital, Boston, MA, USA.
概括
罗斯/罗斯-康诺手术显著降低了主动脉狭窄和左心室外流通道阻塞的患者内心纤维延 (EFE) 的复发. 这种方法降低了EFE的再干预率,这种情况通常需要重复手术.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 遗传性心脏病是一种先天性心脏病.
- 心脏外科手术 心脏外科手术
背景情况:
- 内心纤维弹性 (EFE) 在关键的大动脉 (AoV) 狭窄和左心室外流通道阻塞 (LVOTO) 中存在扩张功能障碍和双心室衰竭的风险.
- 目前对EFE的治疗包括切除,但复发很常见,需要重复手术.
研究的目的:
- 评估用于增强左心室出口狭窄的罗斯/罗斯-康诺手术是否可以预防EFE复发.
- 为了比较经过罗斯/罗斯-康诺手术的患者与没有经过手术的患者之间的EFE复发率.
主要方法:
- 一项回顾性分析包括60名在2010年至2021年期间患有AoV狭窄±LVOTO和初级LV EFE切除的患者.
- 根据管理可修改EFE复发风险因素的程序,患者被分为非罗斯或罗斯/罗斯-康诺组.
- 主要结果是EFE的复发.
主要成果:
- 在Ross/Ross-Konno组中,EFE复发在20.7%的人群中被观察到,而非Ross组中为62.2%,这是显著的差异 (P = 0.003).
- 罗斯/罗斯-康诺程序与EFE复发的可能性降低有关 (调整后的危险比率为4.07,P=0.011).
- 在罗斯/罗斯-科诺组中,左心室外流通道/大动脉的再干预显著减少.
结论:
- 罗斯/罗斯-康诺手术似乎是一种有效的策略,可以减少受影响患者的EFE复发和随后的重新干预.
- 需要进行进一步的前性试验,以确定罗斯/罗斯-康诺手术的最佳患者选择和时间,以防止EFE复发.
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