Shone复杂手术后中期预后评估:再手术和死亡危险因素分析

IF 1.3 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiac Surgery Pub Date : 2022-12-29 DOI:10.1111/jocs.17163

Firat Husnu Altin MD, Oktay Korun MD, Okan Yurdakok MD, Murat Cicek MD, Yigit Kilic MD, Arif Selcuk MD, Orhan Bulut MD, Emine Hekim Yilmaz MD, Selma Oktay Ergin MD, Ahmet Sasmazel MD, Numan Ali Aydemir MD

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引用次数: 0

摘要

目的分析双心室修复术患者的中期预后，并评价其死亡率和再手术危险因素。方法回顾性研究2005年至2020年间34例行二尖瓣手术的肖尼综合征患者。结果主动脉缩窄19例(56%)，主动脉下狭窄10例(29%)，主动脉弓发育不全9例(26.5%)，主动脉瓣狭窄9例(26.5%)。24例(70.6%)患者有双肾房颤。相关的左侧血流狭窄病变包括降落伞MV 19例(56%)和二尖瓣上环18例(53%)。术后6个月、1年、2年的再手术成功率分别为84.4%、79.5%、71.5%。总死亡率为20.6%(7例)，中位随访时间为10个月(0-41)。术后6个月、1年和3年的估计生存率分别为83.8%、79.4%和79.4。二尖瓣主动脉瓣(p = 0.017) (HR (95% CI) = 0.130(0.025-0.695)和吊床二尖瓣(p = 0.038) (HR (95% CI) = 11008(1146 - 100)与死亡率相关。结论二尖瓣主动脉瓣吊床二尖瓣的存在可能对预后有不利影响。

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Evaluation of midterm outcomes after Shone's complex surgery: Analysis of reoperation and mortality risk factors

Objective

The midterm results of patients who underwent biventricular repair surgery for Shone's complex were examined, and mortality and reoperation risk factors were evaluated.

Methods

This retrospective study included 34 patients with Shone's complex who underwent mitral valve (MV) surgery between 2005 and 2020.

Results

A total of 19 patients (56%) had coarctation, 10 (29%) patients had subaortic stenosis, 9 (26.5%) patients had a hypoplastic aortic arch (AA), and 9 (26.5%) patients had aortic valve (AV) stenosis. Twenty-four (70.6%) patients had bileaflet AV. Associated left-sided in-flow stenotic lesions included parachute MV in 19 (56%) patients and supramitral ring in 18 (53%) patients. The estimated freedom from reoperation rate on the 6th month, 1 year and 2 years after surgery was 84.4%, 79.5%, and 71.5%, respectively. The overall mortality rate was 20.6% (seven patients) with a median follow-up of 10 months (0–41). The estimated survival rate on the 6th month, 1 year, and 3 years after surgery was 83.8%, 79.4%, and 79.4 respectively. Bicuspid aortic valve (p = .017) (HR (95% CI) = 0.130 (0.025–0.695) and hammock mitral valve (p = .038) (HR (95% CI) = 11,008 (1,146–>100) were associated with mortality.

Conclusion

The presence of a bicuspid aortic valve hammock mitral valve might have an effect on negative effect on the outcome.

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来源期刊

Journal of Cardiac Surgery 医学-外科

CiteScore

2.90

自引率

12.50%

发文量

976

审稿时长

3-8 weeks

期刊介绍： Journal of Cardiac Surgery (JCS) is a peer-reviewed journal devoted to contemporary surgical treatment of cardiac disease. Renown for its detailed "how to" methods, JCS''s well-illustrated, concise technical articles, critical reviews and commentaries are highly valued by dedicated readers worldwide. With Editor-in-Chief Harold Lazar, MD and an internationally prominent editorial board, JCS continues its 20-year history as an important professional resource. Editorial coverage includes biologic support, mechanical cardiac assist and/or replacement and surgical techniques, and features current material on topics such as OPCAB surgery, stented and stentless valves, endovascular stent placement, atrial fibrillation, transplantation, percutaneous valve repair/replacement, left ventricular restoration surgery, immunobiology, and bridges to transplant and recovery. In addition, special sections (Images in Cardiac Surgery, Cardiac Regeneration) and historical reviews stimulate reader interest. The journal also routinely publishes proceedings of important international symposia in a timely manner.