在 Bileaflet 机械动脉置换术后,阴风过度生长的长期发生率和危险因素
Hung Dung Van1,2, Minh Chau Van Nguyen3, Dang Huu Danh1
1Cardiac Surgery Department, Heart Institution of Ho Chi Minh City, 4 Duong Quang Trung Street, Ward Hoa Hung, Ho Chi Minh City 700000, Vietnam.
概括
亚大风中的过度生长是机械大风中替换 (AVR) 后的晚期并发症. 女性的性别,较小的门大小和年轻的年龄增加了风险,而年长的年龄是保护性的. 建议在重新操作时完全去除.
科学领域:
- 心血管外科心血管外科
- 生物材料科学 生物材料科学
- 医疗成像医学成像
背景情况:
- 亚大风中的过度生长是机械大风中替换 (AVR) 后的一个已知的并发症.
- 目前关于下风险的发病率和危险因素的数据有限.
- 这项研究重点关注胆叶片机械,这是AVR中常用的常见类型.
研究的目的:
- 通过胆叶片机械来确定AVR后亚动脉瘤过度生长的发生率.
- 为了确定与下大动脉瘤的发展相关的独立风险因素.
- 为潜在的预防和管理策略提供见解.
主要方法:
- 对1145名用胆叶片机械进行AVR的患者进行了回顾性分析 (1995-2010年).
- 根据成像和手术内确诊狭窄症的基础上,定义了亚动脉.
- 使用竞争性风险分析来计算累积发病率,以及用于风险因素识别的Fine和Grey模型.
主要成果:
- 累计发病率为4.1%,在平均随访时间为16.5年内发展出需要重复手术的脑下大动脉瘤.
- 确定的独立风险因素包括女性性别,较小的假体门尺寸 (≤19毫米或21毫米),以及同时进行的 mitra 门置换.
- 在AVR中,年龄较大被发现是保护因素.
结论:
- 门下瘤过度生长是胆叶叶片机械AVR后的晚发性并发症,发生率逐渐增加.
- 关键的危险因素是女性的性别,更小的假肢尺寸,手术时的年龄较小,以及同时进行的 mitra 门置换.
- 建议在重新手术期间进行完整的帕努斯切除和门更换,需要进一步研究预防.
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