Takeuchi修复术后左心室射血分数和二尖瓣返流的长期评估

IF 1.1 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Revista Brasileira De Cirurgia Cardiovascular Pub Date : 2019-12-01 DOI:10.21470/1678-9741-2018-0376
Gökmen Akkaya, Ç. Bilen, O. Tuncer, M. Ayık, Y. Atay
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引用次数: 1

摘要

目的评价肺动脉源性左冠状动脉异常(ALCAPA)患者初始Takeuchi修复术后的早期手术效果,并比较其左心室和二尖瓣功能。方法14例患者(男5例,女9例;本研究纳入2007年至2018年期间接受ALCAPA手术的患者,平均年龄4.3岁,年龄范围为25天至34岁。根据我们的医疗记录对数据进行回顾性评估。结果住院死亡率为7.1% (n=1)。13例存活患者平均随访4.3±3.05年。与术前测量结果相比,出院前左心室射血分数(LVEF) (P=0.007)和二尖瓣返流(MR) (P=0.001)均显著改善。此外,考虑到术后早期结局,LVEF值在随访后期有所改善,且差异有统计学意义(P=0.014)。然而,在长期随访中,患者MR程度的改变没有差异(P=0.180)。所有患者均无晚期死亡或需要再手术。结论虽然一些中心倾向于直接植入ALCAPA,但Takeuchi手术可以提高左心室射血分数,减少二尖瓣反流,是一种可靠的方法,可以提供满意的长期效果。
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Long-Term Assessment of Left Ventricular Ejection Fraction and Mitral Regurgitation Following Takeuchi Repair
Objective This study aimed to evaluate the early operative outcomes and to compare the left ventricle and mitral valve functions after initial Takeuchi repair in patients with anomalous left coronary arising from pulmonary artery (ALCAPA). Methods Fourteen patients (5 males, 9 females; mean age 4.3 years, ranging from 25 days to 34 years) who were operated for ALCAPA between 2007 and 2018 were included in this study. Data were evaluated retrospectively based on our medical records. Results Hospital mortality rate was 7.1% (n=1). Thirteen surviving patients were kept in follow-up mean 4.3±3.05 years. When compared to preoperative measurements, both left ventricular ejection fraction (LVEF), (P=0.007) and mitral regurgitation (MR) (P=0.001) significantly improved before discharge. Moreover, LVEF values were improved in the late follow-up, considering early postoperative outcomes, and this alteration was significant (P=0.014). Nevertheless, alteration in the degree of MR among patients did not differ in the long-term follow-up (P=0.180). There was no late-term mortality or need for reoperation among patients. Conclusion Although some centers prefer to direct implantation in ALCAPA, Takeuchi procedure can be accepted as a reliable method that provides satisfactory long-term results, considering that it aids to improve left ventricle ejection fraction and reduced mitral valve regurgitation.
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来源期刊
Revista Brasileira De Cirurgia Cardiovascular
Revista Brasileira De Cirurgia Cardiovascular CARDIAC & CARDIOVASCULAR SYSTEMS-SURGERY
CiteScore
2.10
自引率
0.00%
发文量
176
审稿时长
20 weeks
期刊介绍: Brazilian Journal of Cardiovascular Surgery (BJCVS) is the official journal of the Brazilian Society of Cardiovascular Surgery (SBCCV). BJCVS is a bimonthly, peer-reviewed scientific journal, with regular circulation since 1986. BJCVS aims to record the scientific and innovation production in cardiovascular surgery and promote study, improvement and professional updating in the specialty. It has significant impact on cardiovascular surgery practice and related areas.
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