伴随性三管膜整形在心肌手术期间:成为一个不受欢迎的做法?
Alex M Wisniewski1, Ashley Chipoletti1, Raymond J Strobel1
1Division of Cardiothoracic Surgery, University of Virginia, Charlottesville, Virginia.
Annals of thoracic surgery short reports
|December 22, 2025
概括
大型试验公布后,三管解剖手术 (TA) 的发生率显著下降. 在实践中,这种变化没有影响患者的死亡率或其他关键结果,这表明手术决策的转变对中膜手术患者.
科学领域:
- 心血管外科心血管外科
- 心脏外科手术的结果
- 临床试验影响影响
背景情况:
- 在退行性甲骨管吐手术期间同时进行三管除术 (TA) 是有争议的.
- 一项主要的试验表明,TA可以减少三腹吐,但增加了心脏起器风险,但没有改善死亡率或生活质量.
- 本研究评估了试验出版后TA率的变化.
研究的目的:
- 在公布关键试验结果后,量化符合条件的患者的三管解剖手术 (TA) 率.
- 为了评估一项大型临床试验对手术实践的影响,同时进行三管门手术期间的手术干预.
主要方法:
- 一个区域合作项目在2017-2023年间确定了204名患有退行性部吐和中度三管吐的患者.
- 分析了接受米特拉修复或更换的患者,不包括内心炎,初级或严重三回的患者.
- 在试验发表日期之前和之后的1个月的洗期被用来评估实践变化.
主要成果:
- 27.9%的符合条件的患者在试验后期接受了手术.
- 三管修复率显著下降,从试验前的45.6%降至试验后的26.3% (P = .01).
- 基线特征和术后结果,包括死亡率,在试验前和试验后组之间是相似的.
结论:
- 在心胸外科试验网络试验发表后,同时进行三管干预的显着减少.
- 三管解剖手术的外科实践模式因试验证据而改变.
- 这些发现表明,在试验后的 mitra 门手术期间,对中度三管吐的管理有显著的转变.
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