心脏手术后的异常运动:一系列小儿心脏泵术后舞蹈症

IF 2.3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
S. Bernheim, E. Saarda, M. Hully, C.J. Roux, M. Kossorotof, F. Bajolle, D. Bonnet, O. Raisky
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引用次数: 0

摘要

导言:心脏手术后的神经失调主要归因于中风。然而,心脏手术后出现异常运动的原因却很罕见:泵后舞蹈症。这种并发症非常罕见,对其治疗方法和演变过程的描述也很少。结果10年间,内克尔医院共进行了7059例使用心肺旁路(CBP)的小儿心脏手术,11名患者出现了泵后胆囊炎(0.15%),其中包括5名男孩(45%)。诊断出泵后舞蹈症的中位年龄为 5.7 岁 [0.45-9.9]。一名患者早产,无遗传综合征。体重指数中位数较低(14.8 [11.9-17.4])。六名患者患有紫绀型心脏病。六名患者(55%)曾接受过 CBP 手术。CBP 的中位持续时间和在重症监护室的停留时间分别为 132 分钟 [64-362] 和 6 天 [1-186]。从手术到症状出现的时间间隔为 20 天 [4-64],中位时间为 44 天 [3-181]。异常运动主要影响面部(100%),通常为双侧(82%),涉及上肢(91%)和下肢(82%)。最初的脑磁共振成像未显示近期的缺血性病变。六名患者(55%)接受了药物治疗:四苯丙嗪(2例)、静脉注射免疫球蛋白(1例)、皮质类固醇(1例)、左旋多巴(1例)、环丙咪嗪(1例)。结论 泵后舞蹈症极为罕见,可在心脏手术后数月出现。泵后舞蹈症极为罕见,可在心脏手术后数月发生,似乎与围手术期的严重程度标准没有直接关系。确诊后 6 个月内的预后通常良好。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Abnormal movements following heart surgery: A series of pediatric post-pump chorea

Introduction

Neurological disorders following heart surgery are mainly attributable to strokes. However there is a rare cause of abnormal movement following heart surgery: post-pump chorea. This complication is rare and poorly described particularly with regard to its therapeutic management and evolution.

Methods

Descriptive monocentric retrospective study including all children with post-pump chorea over a 10-year period (2014–2023). Clinical presentation, radiological findings, and outcomes were analyzed based on clinical, biological, and cerebral imaging data.

Results

Over 10 years, 7059 pediatric cardiac surgeries with cardiopulmonary bypass (CBP) were performed at Necker hospital, and 11 patients experienced post-pump chorea (0.15%), including 5 boys (45%). Median age at the diagnosis of post-pump chorea was 5.7 years [0.45–9.9]. One patient was premature, and none had genetic syndromes. Median BMI was low (14.8 [11.9–17.4]). Six patients had cyanotic heart disease. Six patients (55%) had previously undergone surgery with CBP. Median CBP duration and length of stay in the intensive care unit were typical, at 132 minutes [64–362] and 6 days [1–186], respectively. The interval between surgery and symptom onset was 20 days [4–64], with a median duration of 44 days [3–181]. Abnormal movements primarily affected the face (100%) and were often bilateral (82%), involving the upper limbs (91%) and lower limbs (82%). Initial cerebral MRI did not show recent ischemic lesions. Six patients (55%) received medical treatment: tetrabenazine (n = 2), intravenous immunoglobulins (n = 1), corticosteroids (n = 1), L-Dopa (n = 1), cyamemazine (n = 1). Chorea persisted beyond 6 months in only 1 out of 11 patients.

Conclusion

Post-pump chorea is extremely rare and can occur several months after cardiac surgery. It does not appear to be directly related to perioperative severity criteria. The prognosis is generally favorable within 6 months following diagnosis.

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来源期刊
Archives of Cardiovascular Diseases
Archives of Cardiovascular Diseases 医学-心血管系统
CiteScore
4.40
自引率
6.70%
发文量
87
审稿时长
34 days
期刊介绍: The Journal publishes original peer-reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches, review articles and editorials. Topics covered include coronary artery and valve diseases, interventional and pediatric cardiology, cardiovascular surgery, cardiomyopathy and heart failure, arrhythmias and stimulation, cardiovascular imaging, vascular medicine and hypertension, epidemiology and risk factors, and large multicenter studies. Archives of Cardiovascular Diseases also publishes abstracts of papers presented at the annual sessions of the Journées Européennes de la Société Française de Cardiologie and the guidelines edited by the French Society of Cardiology.
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