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Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
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在小型胸腔切除术上对脑损伤的根排气的影响:在252名患者中使用手术前和手术后的大脑MRI进行前性评估

Shuhei Nishijima1, Yoshitsugu Nakamura2, Yuka Higuma2

  • 1Department of Cardiovascular Surgery, Chiba-Nishi General Hospital, Matsudo, Chiba, Japan; Department of Cardiovascular Surgery, Sapporo Higashi Tokushukai Hospital, Hokkaido, Japan.

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概括

在微创动脉置换 (MIAVR) 过程中,根气通风可降低无症状脑损伤 (ABI) 的风险. 虽然中风发病率很低,但外科医生应该权衡除气的好处与增加的手术简单性.

关键词:
空气栓塞大脑中风磁共振成像最少侵入性心脏手术根风口

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科学领域:

  • 心血管外科
  • 神经学
  • 医学成像

背景情况:

  • 在心脏手术中预防脑梗塞通常使用根口去除空气.
  • 至少侵入性主动脉置换 (MIAVR) 有较低的气栓风险,导致一些外科医生省略根气通风.
  • 在MIAVR中,根排气对中风和无症状脑损伤的影响需要量化.

研究的目的:

  • 在接受MIAVR的患者中,评估根泄漏对中风和ABI发生率的影响.
  • 为了比较MIAVR期间根除和没有根除的患者之间的结果.

主要方法:

  • 分析了126名接受选择性MIAVR的患者 (R组) 和126名没有 (N组).
  • 所有患者都接受了手术前和手术后的大脑核磁共振成像.
  • 患者根据根排气的存在或不存在进行分类.

主要成果:

  • 无症状脑损伤 (ABI) 的发生率在没有根除 (N) 组 (46%) 与根除 (R) 组 (31%) 相比显著更高.
  • 在整个队列中,只有一个中风发生在R组中.
  • 在R组比N组的ABI发病率更低,特别是对于大腿动脉通道的患者.

结论:

  • 在MIAVR期间的根泄漏与ABI的发病率降低有关.
  • 在MIAVR中使用根通风的决定应该考虑预防ABI和手术简单性之间的权衡.
  • 虽然根排气在减少ABI方面有好处,但在所有MIAVR案件中,它的必要性需要进一步考虑.