漏斗胸手术修复可缓解成年患者右心腔受压并改善心输出量——一项术中经食管超声心动图研究
Surgical repair of pectus excavatum relieves right heart chamber compression and improves cardiac output in adult patients--an intraoperative transesophageal echocardiographic study.
作者信息
Chao Chieh-Ju, Jaroszewski Dawn E, Kumar Preetham N, Ewais MennatAllah M, Appleton Christopher P, Mookadam Farouk, Gotway Michael B, Naqvi Tasneem Z
机构信息
Echocardiography Laboratory, Division of Cardiology, Mayo Clinic, CK 27, 13400 E Shea Boulevard, Scottsdale, AZ, 85259, USA.
Division of Cardiothoracic Surgery, Mayo Clinic, Scottsdale, AZ, USA.
出版信息
Am J Surg. 2015 Dec;210(6):1118-24; discussion 1124-5. doi: 10.1016/j.amjsurg.2015.07.006. Epub 2015 Sep 24.
BACKGROUND
Cardiac compression in pectus excavatum (PE) deformity and effect of PE surgery on cardiac function in adults have been debated. We examined the effect of PE correction on right heart size and cardiac output.
METHODS
A retrospective evaluation was performed of 168 adult patients who underwent a modified Nuss PE repair with intraoperative transesophageal echocardiography from 2011 to 2014. Seventeen patients with prior PE repair undergoing bar removal acted as controls.
RESULTS
Mean age was 33.0 years (range, 18 to 71 years). There was an increase in right atrium (15.1%), tricuspid annulus (10.9%), and right ventricular outflow tract (6.1%) size after surgery (all P < .0001). Right ventricular cardiac output measured in a subset of 42 patients improved by 38%. No change in chamber size or cardiac output occurred before and after bar removal surgery in the control group.
CONCLUSIONS
Surgical correction of PE deformity caused a significant improvement in right heart chamber size and cardiac output.
背景
漏斗胸（PE）畸形中的心脏压迫以及PE手术对成人心功能的影响一直存在争议。我们研究了PE矫正对右心大小和心输出量的影响。
方法
对2011年至2014年间接受改良努斯PE修复术并术中行经食管超声心动图检查的168例成年患者进行回顾性评估。17例曾接受PE修复术并正在取出固定棒的患者作为对照。
结果
平均年龄为33.0岁（范围18至71岁）。术后右心房（15.1%）、三尖瓣环（10.9%）和右心室流出道（6.1%）大小增加（均P <.0001）。在42例患者亚组中测量的右心室心输出量提高了38%。对照组在取出固定棒手术前后腔室大小或心输出量无变化。
结论
PE畸形的手术矫正使右心腔大小和心输出量有显著改善。
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