Heart:成人先天性心脏病心脏导管介入的复杂性和安全性结局

2020-03-28 xiangting MedSci原创

这项研究表明,ACHD导管介入治疗的复杂性不断增加,病种不断扩大,而这与主要并发症的发生率低、住院时间短和早中期死亡率低相关。

这项研究旨在描述一个当代成人先天性心脏病(ACHD)三级队列中导管介入的治疗范围、复杂性和安全性结局。

纳入2000年至2016年于作者所在中心因ACHD接受导管介入的所有16岁以上患者。分析了基线人口学、临床特征、介入的适应症和复杂性、手术并发症以及早期和中期死亡率。

共进行了1644例基于导管的介入治疗。介入的复杂性从简单(67.5%)到中度(26.4%)到高度(6.1%)不等。常见的手术是房间隔缺损(33.4%)和卵圆孔未闭封堵(26.1%),然后是主动脉缩窄(11.1%)和肺动脉介入(7.0%)。介入时的年龄为40±16岁,758例(46.1%)为男性,73.2%为纽约心脏病协会(NYHA)功能分级I级,20.2%为NYHA II级,而6.6%为NYHA III/IV级。院内死亡率为0.7%。介入后的中位住院时间为1天。并发症129例(7.9%),重大不良事件21例(1.3%)。介入后1年生存率为98.7%(95%CI为98.2-99.2)。研究期间,介入的复杂性发生了显著变化,早期主要为简单手术,而后期则主要为较复杂手术。此外,在研究过程中,病例组合通过基于导管的新介入方法和更个性化的治疗方法得到了扩展(p<0.001)。

这项研究表明,ACHD导管介入治疗的复杂性不断增加,病种不断扩大,而这与主要并发症的发生率低、住院时间短和早中期死亡率低相关。有必要对ACHD导管介入进行持续投资。

原始出处:

Margarita Brida. Cardiac catheter intervention complexity and safety outcomes in adult congenital heart disease. Heart. 23 March 2020.

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    2020-03-30 zhaojie88
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    2020-03-30 huirong
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    2020-03-30 slcumt
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