在全国范围内进行的倾向匹配比较中,亚库布手术与本托尔手术的长期疗效比较

IF 1.3 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Jan Gofus, Jiri Jarkovsky, Anna Klechova, Jaroslav Hlubocky, Stepan Cerny, Martin Urban, Pavel Zacek, Jan Vojacek
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引用次数: 0

摘要

背景。对于患有主动脉根部动脉瘤并伴有或不伴有主动脉瓣反流的患者,使用复合机械瓣膜移植术(Bentall 手术)进行主动脉根部置换一直是一种推荐策略。主动脉根部重塑术(Yacoub 手术)作为一种保留瓣膜的替代方法已经出现,但目前只有很少的多中心证据。我们的研究旨在对这两种策略进行全国范围的比较。研究方法这是一项对全国心脏手术登记数据的回顾性研究。通过倾向分数匹配,我们将 2010 年至 2021 年期间在捷克共和国接受 Bentall 手术的所有患者与在四个经验丰富的中心接受 Yacoub 手术的患者进行了比较。研究结果在研究期间,199 名患者接受了 Yacoub 手术,526 名患者接受了 Bentall 手术。其中,166 对患者被选中并进行了比较。在 5.7 年和 6.4 年的随访期间,围手术期结果和死亡率没有明显差异(P = 0.96)。Bentall手术导致大出血或血栓栓塞的风险更高(p = 0.001),而Yacoub手术导致瓣膜功能衰竭再次住院的风险更高(p = 0.01)。结论在一项全国范围的倾向匹配研究中,Bentall和Yacoub手术的长期生存率相似。Yacoub能更好地避免血栓栓塞或出血,但瓣膜功能衰竭的风险较高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Longer-Term Outcomes of the Yacoub versus Bentall Procedure in a Nationwide Propensity-Matched Comparison

Longer-Term Outcomes of the Yacoub versus Bentall Procedure in a Nationwide Propensity-Matched Comparison

Background. Aortic root replacement with a composite mechanical valve graft (Bentall procedure) has been a recommended strategy in patients with aortic root aneurysm with or without aortic regurgitation. Aortic root remodeling (Yacoub procedure) has emerged as a valve-sparing alternative although there is only scarce multicenter evidence. The aim of our study was to provide nationwide comparison of these two strategies. Methods. This was a retrospective study of data from national registry of cardiac surgery. Using propensity-score matching, we compared all the patients undergoing the Bentall procedure in the Czech Republic between 2010 and 2021 with patients after the Yacoub procedure from four experienced centers. Results. During the study period, 199 patients underwent Yacoub and 526 had Bentall procedure. Of those, 166 pairs were selected and compared. There was no significant difference in perioperative outcomes and in mortality (p = 0.96) over the follow-up of 5.7 vs. 6.4 years. The Bentall procedure was associated with a higher risk of major bleeding or thromboembolism (p < 0.001), and the Yacoub procedure led to a higher risk of rehospitalizations for valve failure (p = 0.01). Conclusions. In a nationwide propensity-matched study, Bentall and Yacoub procedures yield similar longer-term survival. Yacoub offers better freedom from thromboembolism or bleeding at the cost of higher risk of valve failure.

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来源期刊
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.
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