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主动脉瓣置换术后患者-人工瓣膜不匹配对长期生存及生活质量的影响

Impact of Patient-Prosthesis Mismatch following Aortic Valve Replacement on Long-Term Survival and Quality of Life.

作者信息

Hoffmann Grischa, Abraham-Westphal Selam, Attmann Tim, Frank Derk, Lutter Georg, Cremer Jochen, Petzina Rainer

机构信息

Universitatsklinikum Schleswig-Holstein Campus Kiel, Kiel, Schleswig-Holstein, Germany.

FEK Friedrich Ebert Krankenhaus Neumunster GmbH, Neumunster, Schleswig-Holstein, Germany.

出版信息

Thorac Cardiovasc Surg. 2020 Mar;68(2):124-130. doi: 10.1055/s-0038-1666973. Epub 2018 Jul 5.

Abstract

BACKGROUND

The impact of patient-prosthesis mismatch (PPM) after aortic valve replacement (AVR) on long-term survival and quality of life (QoL) remains controversial. The objective of this study was to evaluate the impact of PPM on long-term survival and QoL in a large cohort of patients treated with isolated stented biological AVR in a single-center experience.

METHODS

We analyzed data of 632 consecutive patients following isolated stented biological AVR between 2007 and 2012 at our institution. We evaluated the QoL (393 evaluable patients) using the Short Form 12-item Health Survey (SF-12) questionnaire via telephone call and the impact of PPM on long-term survival (533 evaluable patients) by Kaplan-Meier's estimate.

RESULTS

Severe PPM (<0.65 cm/m) had a negative impact on physical component summary (PCS) score (SF-12) compared with patients with moderate or no PPM ( = 0.014), while the mental component summary (MCS) score (SF-12) was not affected by the degree of PPM ( = 0.133). Long-term survival was not different among the three different PPM groups investigated ( = 0.75).

CONCLUSION

Severity of PPM demonstrated no influence on long-term survival and MCS score (SF-12), but it was associated with a lower PCS score (SF-12) in patients with severe PPM.

摘要

背景

主动脉瓣置换术(AVR)后患者-人工瓣膜不匹配(PPM)对长期生存和生活质量(QoL)的影响仍存在争议。本研究的目的是在单中心经验中,评估PPM对一大群接受孤立带支架生物主动脉瓣置换术治疗患者的长期生存和生活质量的影响。

方法

我们分析了2007年至2012年在我们机构接受孤立带支架生物主动脉瓣置换术的632例连续患者的数据。我们通过电话使用简短健康调查问卷(SF-12)评估生活质量(393例可评估患者),并通过Kaplan-Meier估计评估PPM对长期生存的影响(533例可评估患者)。

结果

与中度或无PPM的患者相比,严重PPM(<0.65 cm/m)对身体成分总结(PCS)评分(SF-12)有负面影响(P = 0.014),而心理成分总结(MCS)评分(SF-12)不受PPM程度的影响(P = 0.133)。在所研究的三个不同PPM组中,长期生存率没有差异(P = 0.75)。

结论

PPM的严重程度对长期生存和MCS评分(SF-12)没有影响,但与严重PPM患者较低的PCS评分(SF-12)相关。

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