JACC:保留主动脉瓣膜手术治疗马凡氏综合征预后

2015-09-22 崔倩 译 MedSci原创

在许多心脏单位中,保留主动脉瓣手术已成为首选外科手术方法治疗马凡氏综合征患者主动脉根部瘤,但只是基于相对短期的成果。本研究旨在探讨保留主动脉瓣膜手术治疗马凡氏综合征患者的长期疗效。本研究的参与者来自于从1988年到2012年所有进行主动脉根部瘤手术的马凡氏综合征患者,前瞻性随访中位数为10年。随访率为100%完成。使用Kaplan-Meier法与数秩检验进行比较,计算了时间-事件分析。总共有146

在许多心脏单位中,保留主动脉瓣手术已成为治疗马凡氏综合征患者主动脉根部瘤的首选外科手术方法,但之前普遍认为这只是基于相对短期的成果。

本研究旨在探讨保留主动脉瓣膜手术治疗马凡氏综合征患者的长期疗效。

本研究的参与者来自于从1988年到2012年所有进行主动脉根部瘤手术的马凡氏综合征患者,前瞻性随访中位数为10年。随访率为100%完成。使用Kaplan-Meier法与数秩检验进行比较,计算了时间-事件分析。

总共有146例马凡氏综合征患者进行了保留主动脉瓣手术。121例患者进行了主动脉瓣再植术,25例患者进行了主动脉根部重建术。平均年龄为35.7±11.4岁,三分之二为男性。术前9例患者为急性,2例为慢性A型,3例为慢性B型主动脉夹层。共有1例手术,后期有6人死亡,其中5例是由解剖的并发症引起的。在15年时的死亡率为6.8±2.9%,与年龄和性别匹配后高于一般人群。5例患者需对主动脉瓣再次手术:2例为心内膜炎,3例为主动脉瓣关闭不全。3例患者发生严重,4例患者发生中度,3例患者发生轻度-中度主动脉瓣关闭不全事件。在15年时主动脉瓣关闭不全的概率为7.9±3.3%,再植术后比重建术后概率低。九例患者在随访过程中制定了新的远端主动脉夹层。在15年时的分离率为16.5±3.4%。

保留主动脉瓣手术治疗马凡氏综合征患者,在长期随访过程中,与瓣膜相关的并发症发生率较低。残留的和新的主动脉夹层是死亡的首要原因。

原始出处:

Tirone E. David,Carolyn M. David,Cedric Manlhiot,et al.Outcomes of Aortic Valve-Sparing Operations in Marfan Syndrome,JACC,2015.9.22

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    2015-12-03 hbwxf
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  5. 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  6. 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  7. 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  8. 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  9. 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    2015-09-23 x35042875

    解读EMPA-REG OUTCOME研究 作者:河北省人民医院 郭艺芳 在2015年EASD年会期间,揭晓了举世瞩目的降糖治疗试验EMPA-REG OUTCOME研究结果。

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