动脉切换手术进入生命的第三和第四十年
Tyson A Fricke1, Jules Frissen2, Sophie Bonser3
1Department of Cardiothoracic Surgery, The Royal Children's Hospital, Melbourne, Australia; University of Melbourne, Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia.
The Journal of thoracic and cardiovascular surgery
|September 13, 2025
概括
动脉切换手术 (ASO) 的成年幸存者具有良好的长期结果,尽管四分之一可能需要在30年内重新手术. 诸如陶西格-宾异常等特定疾病增加了新动脉根或门手术的风险.
科学领域:
- 心脏病学 心脏病学
- 遗传性心脏病是一种先天性心脏病.
- 成年人的先天性心脏病
背景情况:
- 动脉切换手术 (ASO) 是大动脉d转移的常见手术修复.
- 随着ASO后成年幸存者的数量不断增加,需要了解他们的长期健康结果.
研究的目的:
- 评估在接受动脉切换手术 (ASO) 的成年患者的晚期临床结果.
- 为了确定与新动脉根或膜的重新手术相关的风险因素.
主要方法:
- 在1983年至2020年期间在一个机构接受ASO的1010名患者的回顾性审查.
- 对长期后续数据的分析,包括免于重新干预和重新操作率的数据.
- 多变量分析以确定新动脉根或门重新操作的风险因素.
主要成果:
- 从任何重新干预的自由是75%在30年和73%在35年后ASO.
- 在新动脉根或门上,无需重新手术的比例在30岁时为89%,在35岁时为87%.
- 新动脉再手术的危险因素包括陶西格-宾异常,双状新动脉,以及更长的心肺绕道时间.
- 随访时间超过30年的92%的患者属于纽约心脏协会I类.
结论:
- 大多数ASO的成年幸存者保持良好的功能状态.
- 大约四分之一的患者需要在ASO后30年重新手术.
- 患有陶西格 - 宾异常和双状风脉的患者患有风脉根或风脉手术的风险更高.
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