On-X 二尖瓣置换术对感染性心内膜炎病例的益处

IF 1.3 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiac Surgery Pub Date : 2024-02-15 DOI:10.1155/2024/3482523

Manabu Shiraishi, Hiroki Arai, Shigeto Tokunaga, Kengo Teshima, Naoyuki Kimura, Atsushi Yamaguchi

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引用次数: 0

摘要

目的。严重感染性心内膜炎（IE）患者必须进行二尖瓣置换术（MVR）。由于 On-X 瓣膜有望有效减少假体相关的湍流血流，我们研究了在二尖瓣 IE 病例中将 On-X 瓣膜用于 MVR 时的血流动力学疗效。方法。我们比较了两组因二尖瓣 IE 而接受 MVR 的患者的术后效果：13 例患者使用 On-X 瓣膜，27 例患者使用 SJM 瓣膜。结果。无院内死亡病例。晚期死亡有 6 例，均发生在 SJM 组（P=0.1520）。On-X 组术后晚期心房颤动的发生率相对较低（1 例 vs. 10 例，P=0.068）。单变量分析显示，有效孔面积与术后心房颤动之间存在关联。On-X 组的有效孔面积和指数有效孔面积明显更大，分别为 2.8 ± 0.7 cm2 vs. 2.2 ± 0.5 cm2（P=0.007）和 1.8 ± 0.5 cm2/m2 vs. 1.4 ± 0.4 cm2（P=0.003）。结论。在 IE MVR 中使用 On-X 瓣膜可减少左房负荷，这可能会降低术后心房颤动的发生率。

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Benefits of On-X Mitral Valve Replacement in Cases of Infective Endocarditis

Purpose. Mitral valve replacement (MVR) is necessary in cases of severe infective endocarditis (IE). Because the On-X valve is expected to be effective in reducing prosthesis-associated turbulent blood flow, we investigated the hemodynamic efficacy of the On-X valve when used for MVR in cases of mitral valve IE. Methods. We compared postoperative outcomes between two groups of patients who underwent MVR for IE: 13 given an On-X valve and 27 given an SJM valve. Results. There were no in-hospital deaths. Late death occurred in 6 cases, all in the SJM group (P = 0.1520). The incidence of late postoperative atrial fibrillation was relatively low in the On-X group (1 case vs. 10 cases, P = 0.068). Univariate analysis showed an association between the effective orifice area and postoperative atrial fibrillation. The effective orifice area and indexed effective orifice area were significantly larger in the On-X group at 2.8 ± 0.7 cm² vs. 2.2 ± 0.5 cm² (P = 0.007) and 1.8 ± 0.5 cm²/m² vs. 1.4 ± 0.4 cm² (P = 0.003), respectively. Conclusions. The suggested reduction in left atrial load attributed to the use of the On-X valve in MVR for IE may reduce the incidence of postoperative atrial fibrillation.

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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.