选择性门节约性根置换中的性别差异:来自多中心研究的证据
Murat Yildiz1,2, Maria Nucera2, Maximillian Kreibich3
1Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA.
概括
接受节节根置换 (VSRR) 的女性具有独特的特征,但经历的长期结果与男性相似. 基于索引大动脉测量的早期转诊可能会改善女性的识别和结果.
科学领域:
- 心血管外科心血管外科
- 胸前大动脉疾病 胸前大动脉疾病
- 在医学上基于性别的差异.
背景情况:
- 心血管疾病的性别相关差异已经确立,但它们对节约根置换 (VSRR) 后的结果的具体影响仍然不清楚.
- 了解这些差异对于优化VSRR患者护理和手术策略至关重要.
研究的目的:
- 评估接受选择性VSRR.患者的临床特征,放射特征和长期结果的基于性别的差异.
- 确定影响结果的潜在因素,并为未来的管理策略提供信息.
主要方法:
- 在三个大批量国际中心 (2004-2024) 接受VSRR的1,019名患者的回顾性分析.
- 基线,操作和成像数据的性别比较.
- 倾向性得分匹配 (4:1) 调整基线不平衡和Kaplan-Meier/竞争风险分析的结果.
主要成果:
- 女性 (19%) 较年轻,更容易患有遗传性胸前大动脉疾病,绝对大动脉直径较小,但指数维度较大,与男性相比.
- 在女性中,大动脉叶片修复的频率较低.
- 在匹配后,在早期结果中没有观察到任何显著的性别差异;10年免受复合终点 (死亡率,中风,重新干预) 的影响是相似的 (82.8%与83.9%对比).
结论:
- 尽管基线特征不同,但VSRR后的长期结果在性别之间是相同的.
- 仅仅是性别似乎并不能决定VSRR中的手术结果.
- 早期的女性手术转诊,以索引大动脉测量为指导,可以提高识别和改善结果.
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