在连续流动左心室辅助装置植入过程中,同时进行大动脉吐手术改善了生存率
Hiroki Kohno1, Goro Matsumiya1, Yoshikatsu Saiki2
1Department of Cardiovascular Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
概括
在左心室辅助装置 (LVAD) 植入期间纠正大动脉反 (AR) 可能会改善老年患者的长期存活率. 这项研究发现,AR纠正减少了显著的AR发展,并显示了老年人的生存益处.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 医疗器械 医疗器械
背景情况:
- 渐进性大动脉反 (AR) 在左心室辅助器件 (LVAD) 支持期间存在风险.
- 在LVAD植入后纠正AR并没有始终显示出生存益处.
研究的目的:
- 评估同时进行的AR校正对LVAD接受者的结果的影响.
- 为了确定AR纠正是否对AR的发展,死亡率和再接收率有重大影响.
主要方法:
- 对300名日本LVAD接受者进行了回顾性分析,他们之前已经存在AR.
- 接受AR正的患者 (n=77) 和没有接受AR正的患者 (n=223) 的比较.
- 倾向性得分与基线差异的控制匹配,并分析结果.
主要成果:
- 对AR的纠正与较低的显著AR发病率有关.
- 虽然整体死亡率最初相似,但匹配分析表明,未经纠正的AR死亡率更高.
- 老年患者 (≥57岁) 呈现了改善AR正后生存率的趋势,特别是那些轻度AR患者.
结论:
- 纠正先前存在的AR,包括轻度的AR,可能会提高老年LVAD患者的长期存活率.
- 在LVAD植入过程中,年龄似乎是对AR纠正的好处的一个重要因素.
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