在感染性内心炎的门手术中进行术前冠状动脉评估:多中心回顾性研究的发现
Lucas Armange1,2, Pauline Blanc Petitjean3, Audrey Le Bot4
1Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France. luarmange@gmail.com.
概括
在感染性内心炎 (IE) 手术前建议进行术前冠状动脉评估,但未得到充分利用. 这种评估是安全的,可以识别冠状动脉疾病 (CAD),但不应该推迟紧急的门手术.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 传染性内心炎感染性内心炎
背景情况:
- 国际指导方针建议在手术前对感染性内心炎 (IE) 患者进行侵入性冠状动脉血管学 (ICA) 或冠状动脉计算机断层扫描血管学 (CCTA).
- 支持这一建议的证据有限,促使对其临床影响进行调查.
研究的目的:
- 评估手术前冠状动脉评估对接受心脏手术的IE患者的影响和患病率.
- 评估与这群人群冠状动脉评估相关的安全性和结果.
主要方法:
- 一项多中心的回顾性研究包括323名心脏外科手术前冠状动脉状况不明的成年IE患者.
- 患者被分为接受冠状动脉评估 (C组) 和未接受冠状动脉评估 (NC组) 的患者.
- 终点包括冠状动脉评估的流行率,安全性,再血管化率和一年的术后预后.
主要成果:
- 在57%的患者中进行了冠状动脉评估;149人进行了ICA,35人进行了CCTA.
- 显著的冠状动脉疾病 (CAD) 在20.1%的评估患者中被发现.
- 侵入性冠状动脉血管学 (ICA) 显示出良好的耐受性,没有栓塞性事件或额外的毒性.
结论:
- 术前冠状动脉评估是安全和有用的,用于识别IE患者的CAD.
- 尽管有建议,冠状动脉评估仍未得到充分利用,不应阻碍紧急的膜手术.
相关概念视频
Endocarditis III: Medical Management
200
Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
200
Endocarditis II: Clinical Features of Infective Endocarditis
381
Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
381
Endocarditis I: Introduction
371
Introduction:Endocarditis is the infection of the endocardium, the inner lining of the heart and its valves. When the heart muscle is involved, the condition is termed myocarditis, while an infection of the outer lining is called pericarditis. Infective endocarditis (IE) primarily affects the endocardium, where pathogens adhere to the valves or lining, forming vegetation that can lead to severe complications. Infective endocarditis occurs when microorganisms, usually bacteria from other body...
371
Endocarditis IV: Nursing Management
305
Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...
305
Acute Coronary Syndrome III: Diagnostic Studies
200
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
200
Cardiac Catheterization I: Pre-Procedure Overview
1.0K
Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
1.0K


