对于心房功能性心脏回与心室功能性心脏回的 mitra 门手术的结果
Sophia R Pyeatte1, Mehran Rahimi1, Maxwell C Braasch1
1Division of Cardiothoracic Surgery, Department of Surgery, Washington University in St Louis School of Medicine, St. Louis, MO 63110, United States.
概括
与心室功能性 mitrale regurgitation (VFMR) 相比,心房功能性 mitrale regurgitation (AFMR) 手术显示了较好的长期存活率. 对AFMR患者来说,关手术 (MVS) 可能更有益,这需要进一步的亚型调查.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 心脏门疾病 心脏门疾病
背景情况:
- 耳前功能性心肌反 (AFMR) 是一种功能性心肌反 (FMR) 的独特形式.
- 仅有有限的数据可以比较AFMR和心室FMR (VFMR) 之间的手术结果.
研究的目的:
- 为了比较米特拉手术 (MVS) 在AFMR与VFMR患者的长期结果.
- 为了分析根据AFMR亚型分层的结果:只有心房动 (AF),只有心力衰竭与保存的喷射分数 (HFpEF),或结合AF和HFpEF.
主要方法:
- 在2000年至2022年期间,对在2000年至2022年期间为非退行性,中度至重度的 mitrale regurgitation (MR) 进行 MVS 的患者进行了回顾性审查.
- 根据14个手术前变量进行1:1的倾向性得分匹配,以比较AFMR和VFMR组.
- 主要终点包括累积存活率和MVS失败 (复发性MR或重新操作);二级分析检查了AFMR亚型.
主要成果:
- 倾向匹配确定了92对AFMR和VFMR患者.
- 在AFMR组显示较低的手术死亡率 (3.3%对13%,P=0.03) 和改善的累积存活率 (P=0.039).
- 额头骨修复率相似,但AFMR患者同时进行CABG的次数较少,并进行更多的切除.
结论:
- 与VFMR相比,关手术 (MVS) 与AFMR患者的长期存活率有所改善.
- MVS似乎对AFMR有益,AFMR亚型之间的潜在差异需要进一步研究.
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