全球精选文摘 - 微创二尖瓣修复手术后十年：长期预后

高级搜索

免费注册

首页

期刊文献

全球精选文摘

中国作者重要发表

爱思唯尔期刊精选全文

柳叶刀中文版精选全文

2009年诺贝尔奖得主文章

成功投稿经验系列访谈

2010年度诺贝尔奖得主

医药资讯

医学资讯

药品动态

诊疗指南

病例分析

数据库

会议精粹

柳叶刀流感峰会

2009世界高血压大会

辉瑞中国医学研究高峰论坛

上海东方呼吸病国际论坛

GAP-CCBC系列会议

精品书籍

爱思唯尔参考书

新书订购活动

疾病资源

专家博客

当前位置 > > > >

微创二尖瓣修复手术后十年：长期预后

A Decade of Minimally Invasive Mitral Repair: Long-Term Outcomes

Galloway AC, Schwartz CF, Ribakove GH 2010/1/13 11:12:35

【发表评论】【全球专家评论】

打印| 推荐给好友

Ann Thorac Surg, 2009,

专家评级：

★★★

循证评级：

View at Publisher

Background:
Short-term results with minimally invasive approaches for mitral valve repair in degenerative disease have been encouraging, with potential for diminishing blood loss and hospital length of stay. Little is known, however, about the long-term efficacy of this approach. This report analyzes a single institution's results over 12 years with minimally invasive mitral repair.

Methods:
Since 1986, 3,057 patients have undergone mitral valve repair; 1,601 patients had degenerative disease and are the subject of this report. Minimally invasive mitral repair was done in 1071 patients with a right anterior minithoracotomy and direct vision. Clinical and echocardiographic variables were entered prospectively into a database.

Results:
Hospital mortality was 2.2% for all patients (36 of 1601); 1.3% for isolated minimally invasive (9 of 712) and 1.3% (3 of 223) for isolated sternotomy mitral valve repair; and 3.6% (24 of 666) for valve repair plus a concomitant cardiac procedure. For isolated valve repair, 8-year freedom from reoperation was 91%±2% for sternotomy and 95%±1% for minimally invasive (p=0.24), and 8-year freedom from reoperation or severe recurrent insufficiency was 90%±2% for sternotomy and 93%±1% for minimally invasive (p=0.30). Eight-year freedom from all valve-related complications was 86%±3% for sternotomy and 90%±2% for minimally invasive (p=0.14).

Conclusions:
These data indicate that long-term outcomes after minimally invasive mitral repair are excellent and equivalent to results achieved with sternotomy. In view of previously published advantages of short-term morbidity, minimally invasive approaches to mitral valve surgery deserve expanded use.

请登录后发表评论，点击此处登录。

全部学科

疾病资源中心

高血压	慢性阻塞性肺病
脂肪性肝病	糖尿病
卒中	肺癌
冠心病	子宫内膜异位症
结直肠癌	乳腺癌
心力衰竭	心律失常

病例分析 [栏目介绍]

甲状腺功能亢进合并黄疸

王燕燕王曙

上海交通大学附属瑞金医院内分泌科

患者，女，69岁。2009年1月无明显诱因下出现乏力，当时程度较轻，未予以重视。2009年3月患者乏力症状加重，尿色逐渐加深，大便习惯改变，颜色变淡。4月18日入我院感染科治疗，诉轻度头晕、心慌，体重减轻10kg。无肝区疼痛，无发热，无腹痛、腹泻、腹胀、里急后重，无恶性、呕吐等。入院半月前于外院就诊，查肝功能：ALT 601IU/L，AST 785IU/L，TBIL 97.7umol/L，白蛋白 41g/L，甲状腺功能：游离T3 30.6pmol/L，游离T4 51.9pmol/L，心电图示快速房颤。

更多>>>

医学数据库