重做二尖瓣手术中主动脉内夹钳的临床影响

IF 2.4 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Cristina Barbero, Andrea Costamagna, Peter Verbrugghe, Joseph Zacharias, Frank Van Praet, Thierry Bove, Alfonso Agnino, Jörg Kempfert, Mauro Rinaldi
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引用次数: 0

摘要

这项研究的目的是比较接受右小胸廓切开术和EAC手术的中风再手术患者与接受其他方法手术的中风再手术患者。对来自欧洲 7 个中心的重做中风患者进行了分析。主要终点是30天死亡率;次要终点是中风、再次手术、低心排量综合征(LCOS)、呼吸衰竭、重症监护室(ICU)和住院时间。49名患者(22.7%)接受了右侧小胸腔切开术和EAC手术,167名患者(77.3%)通过其他方法接受了手术(112例胸骨切开术、40例未钳夹的小胸腔切开术和15例经胸腔钳夹的小胸腔切开术)。30天死亡率、中风、因出血再次手术和断奶失败率相当。EAC 组的 LCOS 发生率明显降低(p = 0.03),ICU(p = 0.04)和住院时间(p = 0.002)明显缩短。EAC 使外科医生能够触及主动脉、钳夹主动脉并以 "无接触 "技术提供心脏麻痹,显著改善了预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Clinical Impact of the Endo-aortic Clamp for Redo Mitral Valve Surgery

Clinical Impact of the Endo-aortic Clamp for Redo Mitral Valve Surgery

Aim of this study was to compare redo MV surgery patients undergoing right mini-thoracotomy and EAC with redo MV patients undergoing surgery through other approaches. Redo MV patients from 7 European centers were analyzed. Primary endpoint was 30-day mortality; secondary endpoints were stroke, re-exploration, low cardiac output syndrome (LCOS), respiratory failure, and intensive care unit (ICU) and in-hospital length-of-stay. Forty-nine patients underwent right mini-thoracotomy and EAC (22.7%), and 167 (77.3%) underwent surgery through other approaches (112 sternotomy, 40 unclamped mini-thoracotomies, and 15 mini-thoracotomies with trans-thoracic clamp). Thirty-day mortality, stroke, re-exploration for bleeding, and weaning failure were comparable. The EAC group showed significant lower rate of LCOS (p = 0.03) and shorter ICU (p = 0.04) and in-hospital length of stay (p = 0.002). The EAC allows the surgeon to reach the aorta, to clamp it, and to deliver the cardioplegia with a “no-touch” technique, with significant improvement in outcomes.

Graphical Abstract

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来源期刊
Journal of Cardiovascular Translational Research
Journal of Cardiovascular Translational Research CARDIAC & CARDIOVASCULAR SYSTEMS-MEDICINE, RESEARCH & EXPERIMENTAL
CiteScore
6.10
自引率
2.90%
发文量
148
审稿时长
6-12 weeks
期刊介绍: Journal of Cardiovascular Translational Research (JCTR) is a premier journal in cardiovascular translational research. JCTR is the journal of choice for authors seeking the broadest audience for emerging technologies, therapies and diagnostics, pre-clinical research, and first-in-man clinical trials. JCTR''s intent is to provide a forum for critical evaluation of the novel cardiovascular science, to showcase important and clinically relevant aspects of the new research, as well as to discuss the impediments that may need to be overcome during the translation to patient care.
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