[Adapted scale for analysis of necessary septal myectomy in aortic valve replacement].

Q4 Medicine Khirurgiya Pub Date : 2024-01-01 DOI:10.17116/hirurgia202412235
M A Fomin, E P Evseev, E V Balakin, Ya A Aidamirov, A A Botashev, V A Ivanov, T G Nikityuk
{"title":"[Adapted scale for analysis of necessary septal myectomy in aortic valve replacement].","authors":"M A Fomin, E P Evseev, E V Balakin, Ya A Aidamirov, A A Botashev, V A Ivanov, T G Nikityuk","doi":"10.17116/hirurgia202412235","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To develop the adapted scale for analysis of necessary septal myectomy (SME) in aortic valve replacement (AVR) for severe aortic stenosis.</p><p><strong>Material and methods: </strong>A retrospective and prospective analysis included 180 patients with severe aortic stenosis and interventricular septal hypertrophy ≥1.5 cm who underwent surgery between 2012 and 2024. Age of patients was 64 (61; 67.3) years. There were 96 (53.3%) men and 84 (46.7%) women. Heart failure NYHA class III was observed in 98 patients (54.4%), class II in 54 (30.0%) patients. The AVR+SME group included 100 patients, and the AVR group included 80 patients. Both groups did not differ in preoperative clinical and echocardiography characteristics.</p><p><strong>Results: </strong>Logistic regression was performed to identify significant predictors. Multivariate analysis provided logistic function including 3 predictors: IVST / PWT, indexed LV myocardial mass and aortic annulus diameter. Regression model included significant factors obtained at the first stage of analysis. The obtained prognostic model was significant (<i>p</i><0.01). Sensitivity was 77.0%, specificity - 83.8%. IVST/ PWT and indexed LV myocardial mass increase the probability of concomitant SME, while aortic annulus diameter has inverse relationship. The cut-off point for indexed LV myocardial mass is 167.5 g, for IVST/ PWT - 1.15, for aortic annulus diameter - 23.5 mm. Further analysis was performed by assigning a score to each predictor. The total score in two groups was determined. Thus, total score > 83.5 indicates advisability of SME in aortic valve replacement.</p><p><strong>Conclusion: </strong>The new scale for predicting the need for SME in AVR will improve postoperative results.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 12. Vyp. 2","pages":"35-41"},"PeriodicalIF":0.0000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Khirurgiya","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.17116/hirurgia202412235","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0

Abstract

Objective: To develop the adapted scale for analysis of necessary septal myectomy (SME) in aortic valve replacement (AVR) for severe aortic stenosis.

Material and methods: A retrospective and prospective analysis included 180 patients with severe aortic stenosis and interventricular septal hypertrophy ≥1.5 cm who underwent surgery between 2012 and 2024. Age of patients was 64 (61; 67.3) years. There were 96 (53.3%) men and 84 (46.7%) women. Heart failure NYHA class III was observed in 98 patients (54.4%), class II in 54 (30.0%) patients. The AVR+SME group included 100 patients, and the AVR group included 80 patients. Both groups did not differ in preoperative clinical and echocardiography characteristics.

Results: Logistic regression was performed to identify significant predictors. Multivariate analysis provided logistic function including 3 predictors: IVST / PWT, indexed LV myocardial mass and aortic annulus diameter. Regression model included significant factors obtained at the first stage of analysis. The obtained prognostic model was significant (p<0.01). Sensitivity was 77.0%, specificity - 83.8%. IVST/ PWT and indexed LV myocardial mass increase the probability of concomitant SME, while aortic annulus diameter has inverse relationship. The cut-off point for indexed LV myocardial mass is 167.5 g, for IVST/ PWT - 1.15, for aortic annulus diameter - 23.5 mm. Further analysis was performed by assigning a score to each predictor. The total score in two groups was determined. Thus, total score > 83.5 indicates advisability of SME in aortic valve replacement.

Conclusion: The new scale for predicting the need for SME in AVR will improve postoperative results.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
求助全文
约1分钟内获得全文 去求助
来源期刊
Khirurgiya
Khirurgiya Medicine-Medicine (all)
CiteScore
0.70
自引率
0.00%
发文量
161
期刊介绍: Хирургия отдельных областей сердце, сосуды легкие пищевод молочная железа желудок и двенадцатиперстная кишка кишечник желчевыводящие пути печень
期刊最新文献
[Endoscopic stenting for malignant pancreatobiliary strictures]. [Ankle replacement for severe post-traumatic deformation of the distal tibia: a case report]. [Comparative analysis of in-hospital and long-term results of patients with acute dysfunction of coronary bypass grafts depending on treatment tactics]. [Efficacy and safety of surgical treatment of patients with pathological tortuosity of the internal carotid artery]. [Endoscopic vacuum therapy in minimally invasive treatment of esophageal perforations].
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1