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芬坦循环衰竭对心脏移植存活率的影响:20个中心的回顾性队列研究

Kurt R Schumacher ¹, David N Rosenthal ², Adriana Batazzi ¹

¹Congenital Heart Center, Department of Pediatrics, University of Michigan, Ann Arbor (K.R.S., A.B., S.Y., G.R., M.K.C.).
²Department of Pediatrics, Stanford University, Palo Alto, CA (D.N.R.).
³Department of Pediatrics, Division of Cardiology, Children's Health, UT Southwestern, Dallas, TX (M.B.).
⁴Pediatric Cardiology, Children's National Hospital, George Washington University, Washington, DC (S.R.D.).
⁵The Children's Hospital of Philadelphia, PA (M.O., H.A.).
⁶Department of Pediatrics, University of Utah, Salt Lake City (S.C., M.P.).
⁷Nationwide Children's Hospital, Columbus, OH (L.K.W.).
⁸Children's Wisconsin Herma Heart Institute, Department of Pediatrics, Medical College of Wisconsin, Milwaukee (S.J.K.).
⁹Division of Pediatric Cardiology, Ann & Robert Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, IL (A.J.).
¹⁰Pediatrics and Clinical and Translational Science, University of Pittsburgh, PA (B.F.).
¹¹Vanderbilt University Medical Center, Division of Pediatric Cardiology, Nashville, TN (J.G.).
¹²Children's Healthcare of Atlanta, Emory University, GA (C.Y.M.).
¹³Department of Pediatrics, The Heart Institute, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, OH (A.L.).
¹⁴Division of Pediatric Cardiology, Children's Hospital of Colorado, University of Colorado Anschutz Medical Campus, Aurora (K.E.S.).
¹⁵Division of Pediatric Cardiology, Washington University School of Medicine, St Louis, MO (A.Y.).
¹⁶Division of Pediatric Cardiology, Columbia University Vagelos College of Physicians & Surgeons, New York, NY (M.E.R.).
¹⁷Division of Cardiology & Cardiovascular Medicine, Department of Heart, Vascular & Thoracic, Children's Institute, Cleveland, OH (S.A.).
¹⁸Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, Canada (J.C.).
¹⁹Division of Advanced Cardiac Therapies, Boston Children's Hospital, MA (E.D.B.).

⁰Congenital Heart Center, Department of Pediatrics, University of Michigan, Ann Arbor (K.R.S., A.B., S.Y., G.R., M.K.C.).

Circulation +

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2025年七月9日

在PubMed上查看摘要

概括

在等待心脏移植的Fontan循环衰竭患者面临高死亡率. 色和先前住院是从等待名单到移植后一年死亡的关键风险因素.

科学领域

心脏病学
儿童心脏病学
移植手术

背景情况

丰坦循环衰竭 (FCF) 是单心室心脏病的严重并发症,导致高发病率和死亡率.
现有的FCF发病率定义不足,阻碍了对心脏移植结果的影响的研究.
了解FCF特有的风险对于改善心脏移植患者的存活率至关重要.

研究的目的

调查与Fontan循环衰竭相关的发病率对生存的影响.
通过心脏移植等待名单确定心脏移植死亡的特定风险因素.

主要方法

一个回顾性队列研究,涉及20个中心和409名被列入心脏移植名单的Fontan患者 (2008-2022年).
数据包括人口统计,病史,等待名单状态以及移植前后信息.
多变量逻辑回归确定了死亡的独立风险因素.

主要成果

死亡率很高:5.9%的人在等待名单上死亡,8.5%的人在移植后的一年内死亡.
在等待名单和移植后的一年间死亡的独立风险因素包括先前住院和临床色.
特定的发病情况,如左心缺血综合征,Fontan阻塞和门病,与移植后的死亡率有关.

结论

接受心脏移植的Fontan缓解患者具有显著的死亡风险.
临床色是一种与生存率较低相关的关键FCF特异性疾病.
经常入院表明严重的临床发病率, 需要考虑心脏移植.

关键词:

源泉程序心脏缺陷,先天性移植

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