Holmes D R, Nishimura R A, Reeder G S
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905.
J Am Coll Cardiol. 1991 Jan;17(1):189-92. doi: 10.1016/0735-1097(91)90726-p.
Percutaneous balloon aortic valvuloplasty has been accompanied by significant early periprocedural morbidity and mortality. Identification of factors associated with increased mortality might allow for improved selection of patients. The Mansfield Scientific Balloon Aortic Valvuloplasty Registry was analyzed to identify the frequency of in-hospital death and the factors associated with it. Of 492 patients undergoing the procedure, 37 (7.5%) died during the hospital stay in which valvuloplasty was performed. Twenty-four of these patients died within the first 24 h and the remainder died within 7 days after the procedure. There were significant differences in baseline clinical and hemodynamic characteristics as well as procedural and postprocedural variables between patients dying and those surviving the in-hospital period. Multivariate analysis identified four factors associated with increased mortality: 1) the occurrence of a procedure-related complication, 2) a lower initial left ventricular systolic pressure, 3) a smaller final aortic valve area, and 4) a lower baseline cardiac output. Thus, baseline hemodynamic, procedural and postprocedural variables and complications can be identified that are associated with increased mortality.
经皮气球主动脉瓣成形术一直伴随着显著的围手术期早期发病率和死亡率。识别与死亡率增加相关的因素可能有助于改善患者的选择。对曼斯菲尔德科学公司的气球主动脉瓣成形术登记处进行了分析，以确定住院死亡的频率及其相关因素。在接受该手术的492例患者中，有37例（7.5%）在进行瓣膜成形术的住院期间死亡。其中24例患者在术后24小时内死亡，其余患者在术后7天内死亡。死亡患者与住院期间存活患者在基线临床和血流动力学特征以及手术和术后变量方面存在显著差异。多因素分析确定了与死亡率增加相关的四个因素：1）发生与手术相关的并发症；2）初始左心室收缩压较低；3）最终主动脉瓣面积较小；4）基线心输出量较低。因此，可以识别出与死亡率增加相关的基线血流动力学、手术和术后变量及并发症。
