在心外全腔肺连接中进行瓣膜置入术与不进行瓣膜置入术的结果。

IF 0.7 Q3 Medicine
Noppon Taksaudom, Jakaparn Horsatidkul, Thitipong Tepsuwan, Apichat Tantraworasin, Rekwan Sittiwangkul, Amarit Phothikun
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引用次数: 0

摘要

背景:瓣膜全腔肺连接术因其能降低全身静脉压和提高心输出量而受到欢迎。然而,在这种情况下,关于瓣膜的近期和远期优势一直存在争议:一项回顾性队列研究涉及 1999 年 1 月至 2019 年 12 月期间在清迈大学医院接受心外全腔肺连接术的 97 名患者。这些患者最初被分为两组:有瘘管(71 人)和无瘘管(26 人)。在排除和重新分配后,对开窗组(n = 68)和非开窗组(n = 25)的长期结果进行了分析。为了解决两组之间潜在的混杂因素,研究人员使用逻辑回归分析法计算了倾向得分:研究发现,术前和手术数据无明显差异。术后近期结果显示,主要并发症、重症监护室住院时间、血氧饱和度和全腔肺连接后压力均无明显差异。在长期评估中,栅栏组的死亡率、蛋白丢失性肠病、肝脏肿块和肝硬化的发生率明显较低。然而,在采用倾向得分分析多层次模型分层后,只有瓣膜组的长期死亡率明显降低(危险比 = 0.12,95% 置信区间 = 0.02-0.97)。通过自发闭合和设备干预,瘘管通畅率逐渐关闭:结论:研究发现,术后即刻结果没有重大差异。结论:研究发现术后即刻预后无重大差异,但在瘘管队列中,蛋白质丢失性肠病、肝脏肿块、肝硬化和长期死亡率的发生率明显较低。然而,根据倾向得分分析建立的多层次分层模型表明,只有长期死亡率较低才显示出主要影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Outcomes of fenestration versus none in extracardiac total cavopulmonary connection.

Background: Fenestrated total cavopulmonary connection has gained popularity due to its capacity to reduce systemic venous pressure and enhance cardiac output. However, there is ongoing debate about the immediate and long-term advantages of fenestration in this context.

Method: A retrospective cohort study was conducted involving 97 patients who underwent extracardiac total cavopulmonary connection at Chiang Mai University Hospital between January 1999 and December 2019. The patients were initially categorized into two groups: fenestrated (n = 71) and nonfenestrated (n = 26). After exclusion and reassignment, the long-term outcomes were analyzed for the fenestrated (n = 68) and nonfenestrated (n = 25) groups. To address potential confounding factors between the two groups, propensity scores were computed using logistic regression analysis.

Results: The study found no significant differences in preoperative and operative data. Immediate postoperative outcomes showed no significant variations in major complications, intensive care unit stay, oxygen saturation, and posttotal cavopulmonary connection pressure. In the long-term assessment, the fenestrated group demonstrated significantly lower rates of mortality, protein-losing enteropathy, liver mass, and cirrhosis. However, after employing a multilevel model stratified by propensity score analysis, only long-term mortality rate was significantly lower in the fenestrated group (hazard ratio = 0.12, 95% confidence interval = 0.02-0.97). Fenestration patency closed gradually through spontaneous closure and device intervention.

Conclusion: The study found no major differences in immediate postoperative outcomes. In the fenestrated cohort, significantly lower incidences of protein-losing enteropathy, liver mass, cirrhosis, and long-term mortality were observed. However, multilevel model stratified by propensity score analysis indicated that only the lower long-term mortality demonstrated a major effect.

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来源期刊
CiteScore
1.30
自引率
0.00%
发文量
78
期刊介绍: The Asian Cardiovascular and Thoracic Annals is an international peer-reviewed journal pertaining to cardiovascular and thoracic medicine. Besides original clinical manuscripts, we welcome research reports, product reviews, reports of new techniques, and findings of special significance to Asia and the Pacific Rim. Case studies that have significant novel original observations, are instructive, include adequate methodological details and provide conclusions. Workshop proceedings, meetings and book reviews, letters to the editor, and meeting announcements are encouraged along with relevant articles from authors.
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