对于严重左心室功能障碍的大动脉狭窄而进行大动脉置换. 预测指标 预测指标
H M Connolly1, J K Oh, T A Orszulak
1Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Circulation
|May 20, 1997
概括
在患有左心室缩功能障碍的患者中,对大动脉狭窄进行大动脉置换是可行的. 结果是可以接受的,大多数患者经历了症状和射出分数的改善,尽管存活率与冠状动脉疾病有关.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
背景情况:
- 动脉狭窄 (AS) 与左心室 (LV) 缩功能障碍增加了门置换的风险.
- 有限的数据存在于AS患者与LV缩功能障碍的结局.
研究的目的:
- 评估AS和LV系统功能障碍患者的大动脉置换的结果.
主要方法:
- 在1985年至1992年期间,154名LV静脉缩功能障碍患者 (排泄分数≤35%) 接受了AS的大动脉置换.
- 在51%的患者中进行了冠状动脉旁路移植.
- 随访数据分析了死亡率,存活率和喷射分数的变化.
主要成果:
- 术后死亡率为9%.
- 冠状动脉疾病和手术前心脏输出减少是减少存活率的显著预测因素.
- 88%的患者的症状有所改善 (NYHA III/IV类手术前至7%的术后).
- 76%的幸存者在手术后表现出改善的射出分数.
结论:
- 在患有LV功能障碍的患者中,对AS进行大动脉置换是可以接受的.
- 结果受到冠状动脉疾病和平均大动脉梯度的影响.
- 长期生存与冠状动脉疾病和心脏输出有关.
- 大多数患者在症状和喷射分数方面经历了显著改善.
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