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二叶式主动脉瓣患者行主动脉瓣及/或主动脉手术的临床特征和 30 天转归。

Clinical Profile and 30-Day Outcomes of Patients with Bicuspid Aortic Valve Undergoing Aortic Valve and/or Aorta Surgery.

机构信息

Unidade Clínica de Valvopatias - Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo , SP - Brasil.

出版信息

Arq Bras Cardiol. 2022 Mar;118(3):588-596. doi: 10.36660/abc.20201027.

Abstract

BACKGROUND

The bicuspid aortic valve (BAV) affects 0.5 to 2% of the population and is associated with valve and aortic alterations. There is a lack of studies on the profile of these patients in the Brazilian population.

OBJECTIVE

To describe the profile of patients with BAV undergoing valve and/or aortic surgery in a tertiary cardiology center, in addition to the outcomes related to the intervention.

METHODS

Retrospective cohort including 195 patients (mean age 54±14 years, 73.8% male) diagnosed with BAV who underwent surgical approach (valvular and/or aorta) from 2014 to 2019. Clinical data, echocardiographic and tomographic studies were evaluated, as well as characteristics of the intervention and events in 30 days. A value of p<0.05 was considered statistically significant.

RESULTS

We found a high prevalence of aortic aneurysm (56.5%), with a mean diameter of 46.9±10.2 mm. Major aortic regurgitation was found in 25.1% and major aortic stenosis in 54.9%. Isolated aortic valve surgery was performed in 48.2%, isolated aortic surgery in 6.7% and combined surgery in 45.1%. The 30-day mortality was 8.2%. In the multivariate analysis, the predictors of the combined outcome at 30 days (death, atrial fibrillation and reoperation) were age (OR 1.044, 95% CI 1.009-1.081, p=0.014) and left ventricular mass index (OR 1.009, 95% CI 1.000-1.018, p=0.044).

CONCLUSION

Patients with BAV approached in our service have a higher incidence of aortopathy, with the additional need to evaluate the aorta with computed tomography or magnetic resonance imaging.

摘要

背景

二叶式主动脉瓣(BAV)影响 0.5%至 2%的人群,并与瓣膜和主动脉改变相关。在巴西人群中,缺乏对这些患者特征的研究。

目的

描述在一家三级心脏病中心接受瓣膜和/或主动脉手术的 BAV 患者的特征,以及与干预相关的结果。

方法

回顾性队列纳入了 195 名(平均年龄 54±14 岁,73.8%为男性)被诊断为 BAV 并在 2014 年至 2019 年期间接受手术治疗(瓣膜和/或主动脉)的患者。评估了临床数据、超声心动图和断层扫描研究,以及 30 天内的干预特征和事件。p<0.05 被认为具有统计学意义。

结果

我们发现主动脉瘤的高患病率(56.5%),平均直径为 46.9±10.2mm。25.1%存在严重主动脉瓣反流,54.9%存在严重主动脉瓣狭窄。单纯主动脉瓣手术占 48.2%,单纯主动脉手术占 6.7%,联合手术占 45.1%。30 天死亡率为 8.2%。在多变量分析中,30 天联合结局(死亡、心房颤动和再次手术)的预测因素是年龄(OR 1.044,95%CI 1.009-1.081,p=0.014)和左心室质量指数(OR 1.009,95%CI 1.000-1.018,p=0.044)。

结论

在我们的服务中接受治疗的 BAV 患者主动脉病发病率较高,需要额外评估主动脉是否存在计算机断层扫描或磁共振成像异常。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e76b/8959030/26fb257a4561/0066-782X-abc-118-03-0588-gf01.jpg

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