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右心室至肺动脉通道手术后并发假性动脉瘤:发生率和危险因素。

Pseudoaneurysm complicating right ventricle-to-pulmonary artery conduit surgery: Incidence and risk factors.

机构信息

Department of Cardiology, Boston Children's Hospital, Boston, Mass.

Department of Cardiac Surgery, Boston Children's Hospital, Boston, Mass.

出版信息

J Thorac Cardiovasc Surg. 2017 Dec;154(6):2046-2049. doi: 10.1016/j.jtcvs.2017.08.014. Epub 2017 Aug 24.

Abstract

OBJECTIVES

Although pseudoaneurysm is an uncommon complication after right ventricle-to-pulmonary artery conduit placement, it has the potential to cause significant morbidity and mortality.

METHODS

We performed a review of patients with pseudoaneurysms diagnosed at our institution in a 20-year period (from 1995 through 2015) and compared their clinical characteristics with a group of age- and sex-matched control patients.

RESULTS

We found that younger age, smaller size, the diagnosis of tetralogy of Fallot, the use of a pulmonary homograft conduit, the presence of an unrestrictive ventricular septal defect after conduit placement, and having at least systemic right ventricular pressure were all more common in patients who had pseudoaneurysms develop.

CONCLUSIONS

This study is unique in identifying both patient and surgical factors that may predispose to pseudoaneurysm development and can help inform optimal strategies to monitor and evaluate this patient population.

摘要

目的

尽管假性动脉瘤是右心室至肺动脉通道放置后的一种罕见并发症,但它有可能导致严重的发病率和死亡率。

方法

我们对本机构在 20 年间(1995 年至 2015 年)诊断出的假性动脉瘤患者进行了回顾性研究,并将其临床特征与一组年龄和性别匹配的对照组患者进行了比较。

结果

我们发现,年龄较小、体积较小、诊断为法洛四联症、使用肺动脉同种异体移植物通道、通道放置后存在非限制性室间隔缺损、至少存在系统性右心室压力的患者更容易发生假性动脉瘤。

结论

这项研究的独特之处在于确定了可能导致假性动脉瘤发展的患者和手术因素,并有助于为监测和评估这一患者群体提供最佳策略。

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