年轻患者的罗斯手术--一项单中心长期随访研究。

IF 6.5 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Markus Liebrich, Christoph Dingemann, Detlef Roser, Hartwig Schrimm, You-Shan Feng, Wolfgang Hemmer, Joerg Seeburger, Vladimir Voth
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引用次数: 0

摘要

背景:年轻患者的标准主动脉瓣置换手术是生物人工主动脉瓣置换术或机械主动脉瓣置换术。在这项研究中,我们介绍了年轻患者接受罗斯手术的长期结果:方法:1995 年至 2020 年间,我们为 795 名患者实施了带根部置换的罗斯手术。研究终点为总生存率、自体移植和同种移植/RV-PA 导管(RV:右心室;PA:肺动脉)的再手术/再介入率以及严重不良事件的发生率:795名患者(75%为男性,25%为女性;平均年龄为43±14岁)接受了根部置换的Ross手术。30 天死亡率为 1%(8 名患者),95% 置信区间为 [0.48; 1.9]。96%的患者完成了随访,随访时间为 9540 年,平均随访时间为 12 ± 7 年。5年、10年、15年和20年的存活率分别为97% [96; 98]、96% [93; 96]、92% [89; 94]和86% [83; 90]。自体移植物无需再次手术的存活率在10年为94% [92; 96],20年为80% [76; 85]。同种移植物/RV-PA导管存活率在10年和20年分别为95% [93; 97]和85% [81; 90],无须再次手术。有5例大出血,14例血栓栓塞并发症或心肌梗塞,19例心内膜炎:结论:在25年的随访中,Ross手术根部置换术的存活率较高。再次手术和再次介入的比例、发病率和死亡率以及心内膜炎的发生率都很低。因此,对于患有主动脉瓣疾病的年轻患者来说,罗斯手术是一种有效的外科治疗选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Ross Operation in Young Patients-A Single-Center, Long-Term Follow-Up Study.

Background: The standard aortic valve replacement operations in young patients are bioprosthetic or mechanical aortic valve replacement. In this study, we present the long-term results of the Ross operation in young patients.

Methods: The Ross operation with root replacement was performed on 795 patients between 1995 and 2020. The endpoints were overall survival, re-operation/reintervention rates on the autograft and homograft/RV-PA conduit (RV, right ventricle; PA, pulmonary artery), and the occurrence of serious adverse events.

Results: 795 patients (75% male, 25% female; mean age 43 ± 14 years) underwent the Ross operation with root replacement. The 30-day mortality was 1% (8 patients) with a 95% confidence interval of [0.48; 1.9]. The follow-up was 96 % complete and covered 9540 patient-years, with a mean follow-up time of 12 ± 7 years. The survival rates at 5, 10, 15 and 20 years were 97% [96; 98], 96% [93; 96], 92% [89; 94] and 86% [83; 90]. The rate of autograft survival without reoperation was 94% [92; 96] at 10 years and 80% [76; 85] at 20 years. The rate of homograft/RV-PA conduit survival without reoperation was 95% [93; 97] at 10 years and 85% [81; 90] at 20 years. There were 5 cases of hemorrhage, 14 of thromboembolic complications or apoplexy, and 19 of endocarditis.

Conclusion: The Ross operation with root replacement was associated with high survival rates over 25 years of follow-up. The rates of reoperation and reintervention, the morbidity and mortality, and the rate of endocarditis are low. The Ross operation is thus an effective surgical treatment option for young patients with aortic valve disease.

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来源期刊
Deutsches Arzteblatt international
Deutsches Arzteblatt international 医学-医学:内科
CiteScore
4.10
自引率
5.20%
发文量
306
审稿时长
4-8 weeks
期刊介绍: Deutsches Ärzteblatt International is a bilingual (German and English) weekly online journal that focuses on clinical medicine and public health. It serves as the official publication for both the German Medical Association and the National Association of Statutory Health Insurance Physicians. The journal is dedicated to publishing independent, peer-reviewed articles that cover a wide range of clinical medicine disciplines. It also features editorials and a dedicated section for scientific discussion, known as correspondence. The journal aims to provide valuable medical information to its international readership and offers insights into the German medical landscape. Since its launch in January 2008, Deutsches Ärzteblatt International has been recognized and included in several prestigious databases, which helps to ensure its content is accessible and credible to the global medical community. These databases include: Carelit CINAHL (Cumulative Index to Nursing and Allied Health Literature) Compendex DOAJ (Directory of Open Access Journals) EMBASE (Excerpta Medica database) EMNursing GEOBASE (Geoscience & Environmental Data) HINARI (Health InterNetwork Access to Research Initiative) Index Copernicus Medline (MEDLARS Online) Medpilot PsycINFO (Psychological Information Database) Science Citation Index Expanded Scopus By being indexed in these databases, Deutsches Ärzteblatt International's articles are made available to researchers, clinicians, and healthcare professionals worldwide, contributing to the global exchange of medical knowledge and research.
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