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JACC:肺动脉支架置入术的手术成功率与不良事件研究

2016-03-15 崔倩 译 MedSci原创

与肺动脉(PA)支架结果相关的危险因素仍然很难定义。本研究的目的是确定患者和手术特征对不良事件和手术成的效果。研究人员对注册表数据进行了收集,并为双心室循环患者手术成功预先指定了2个定义:1)右心室压双心室循环或PA直径%增加了50减少20%;2)右心室压力减少25%,或PA梯度下降了50%或支架内最小到前支架远端直径>80%的术后比率。手术成功的一个单独的定义基于PA直径归一化,对于单心室

与肺动脉(PA)支架结果相关的危险因素仍然很难定义。

本研究的目的是确定患者和手术特征对不良事件和手术成功的效果。

研究人员对注册表数据进行了收集,并为双心室循环患者手术成功预先指定了2个定义:1)右心室压力减少20%或者PA直径减少50%;2)右心室压力减少25%,或PA梯度下降了50%,或支架内最小到前支架远端直径>80%的术后比率。手术成功的一个单独的定义基于PA直径归一化,对于单心室矫治患者是预先指定的。

在2011年1月和2014年1月间,共有1183例PA支架手术在59个机构的1001例患者中进行;单心室患者进行了262(22%)例手术。根据定义1手术成功率为76%,根据定义2成功率为86%,对于单心室患者为75%。在多变量分析中,根据两个定义,开口处狭窄与手术成功显著相关。总的并发症发生率为14%,经历死亡或主要不良事件(MAE)的患者为9%。根据多变量分析,重量<4公斤,具有单心室,以及紧急状况与死亡或MAEs显著相关。

在该分析中,根据所有的定义成功率>75%,不良反应是比较常见的。开口处狭窄的双心室患者手术成功的可能性更大。单心室患者,且重量<4公斤,或者经历紧急手术的患者死亡或MAE的风险较高。这些发现可能有助于告知患者选择PA支架。

原始出处:

Matthew J. Lewis,Kevin F. Kennedy,Jonathan Ginns,et al.Procedural Success and Adverse Events in Pulmonary Artery Stenting,JACC,2016.3.15

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    2016-05-31 hbwxf
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    2016-09-03 doctorJiangchao

    继续学习

    0

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    2016-09-03 doctorJiangchao

    继续关注

    0

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