再瓣膜手术发病率和死亡率的预后因素

E. Boudiaf, M. Abdelbaki, MO AMRANE.
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摘要

研究目的方法 :2015年1月至2019年12月期间,49例患者接受了复瓣手术,平均年龄51岁(20-67岁),性别比为0.88。结果:80%的患者被归为二尖瓣成形术后功能障碍、新的瓣膜损伤和感染性心内膜炎导致的机械假体移除:结果:80%的患者属于中度风险组(3-5分),预计死亡率在2.90%至2.94%之间。我们的结果显示,这些患者的死亡率为 2.56%。对术后结果的研究发现了一些心脏并发症(28.5%低输出量和37%心律失常)、感染并发症(8%纵隔炎)和神经系统并发症(6%)。手术死亡率的风险因素是多次瓣膜手术(P=0.03)、持续房颤或术后出现房颤(P=0.05)和年龄超过70岁(P=0.04):采用单瓣膜手术进行瓣膜再通手术的手术死亡率、精算生存率和术后功能获益与初次介入手术完全相当;而采用多瓣膜手术进行瓣膜再通手术的手术死亡率明显较高,但精算生存率和功能获益与初次介入手术相当。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prognostic Factors for Morbidity and Mortality in Redux Valve Surgery
Objectives: Redux valve surgery is increasingly common in Algeria, and the aim of this study was to identify the risk factors for hospital morbidity and mortality in this type of surgery. Method :49 patients with a mean age of 51 years (20-67 years) and a sex ratio of 0.88 underwent redux valve surgery between January 2015 and december 2019. 79%), and in almost half of the cases (46%) the first operation was performed in our department; the most frequent reasons for repeat operations were mitral plasty dysfunction, expression of new valve damage and removal of mechanical prostheses due to infective endocarditis. The Euroscore was used to predict operative risk. Results: 80% of our patients were classified in the moderate risk group (score 3-5) with an expected mortality of between 2.90 and 2.94%. Our results show a mortality rate of 2.56% for these patients. The study of post-operative results revealed a number of cardiac complications (28.5% low output and 37% rhythm disorders), infectious complications (8% mediastinitis) and neurological complications (6%). The risk factors for operative mortality were multiple valve procedures (p=0.03), persistent atrial fibrillation or fibrillation that appeared postoperatively (p=0.05) and age over 70 (p=0.04). Conclusion: Valvular redux surgery with a single-valve procedure has an operative morbi-mortality, actuarial survival and post-operative functional benefit that are entirely comparable to those of a primary intervention; whereas in redux surgery with a multi-valvular procedure, the operative morbi-mortality is significantly higher, but the actuarial survival and functional benefit are comparable to those of a primary intervention
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