Thay thế van hai lá qua ống thông cho van sinh học hai lá bị thoái hóa, thất bại trong phẫu thuật van hai lá và van tự nhiên với xơ hóa vòng van hai lá nghiêm trọng: một đánh giá hệ thống và phân tích tổng hợp

Journal of Cardiothoracic Surgery - Tập 16 Số 1 - 2021
Tao You1, Wei Wang2, Kang Yi1, Jie Gao2, Xin Zhang2, Shao-E He2, Xiaomin Xu2, Yan Ma2, Xin-Yao Li2
1Department of Cardiovascular Surgery, Gansu Provincial Hospital, No. 204, Donggang West Road, Lanzhou City, 730000, Gansu Province, China
2Gansu International Scientific and Technological Cooperation Base of Diagnosis and Treatment of Congenital Heart Disease, Lanzhou, China

Tóm tắt

Tóm tắt Đặt vấn đề

Mặc dù công nghệ qua ống thông đã đạt được một số thành công trong lĩnh vực van hai lá, tính khả thi của việc áp dụng nó cho bệnh nhân có van sinh học hai lá bị thoái hóa (van trong van, ViV), thất bại của phẫu thuật van hai lá (van trong vòng, ViR) và xơ hóa vòng van hai lá nghiêm trọng (van trong MAC, ViMAC) chưa được đánh giá hiệu quả.

Phương pháp

Bằng cách tìm kiếm tài liệu đã công bố trước ngày 5 tháng 12 năm 2020 trong bốn cơ sở dữ liệu, chúng tôi đã tìm thấy tất cả tài liệu liên quan đến việc đánh giá tính khả thi của TMViV, TMViR và TMViMAC. Các kết quả tập trung vào tỷ lệ tử vong mọi nguyên nhân trong 30 ngày, chảy máu và tắc nghẽn lối thoát thất trái (LVOT).

Kết quả

Tổng cộng có sáu nghiên cứu đã được đưa vào, và tất cả đều được theo dõi ít nhất 30 ngày. Sau khi phân tích nhóm ViV- ViR, chúng tôi thu được kết quả như sau: tỷ lệ tử vong mọi nguyên nhân trong 30 ngày của nhóm ViV thấp hơn so với nhóm ViR. Chảy máu đe dọa tính mạng hoặc tử vong có khả năng xảy ra cao hơn ở nhóm ViR sau phẫu thuật. Đồng thời, nhóm ViR có xu hướng dễ bị tắc nghẽn lối thoát thất trái hơn. Tuy nhiên, trong nhóm ViMAC- ViR, chỉ có tỷ lệ tử vong mọi nguyên nhân trong 30 ngày và đột quỵ là có ý nghĩa thống kê. Trong so sánh gián tiếp, chúng tôi phát hiện rằng TMViV có tính ứng dụng tốt nhất, tiếp theo là TMViR. Số lượng TMViMAC có sẵn để phân tích rất ít, và cần có thêm các nghiên cứu để cải thiện độ chính xác của kết quả.

Từ khóa

#TMViV #TMViR #TMViMAC #phẫu thuật van hai lá #xơ hóa vòng van hai lá

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