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find Author "刘成伟" 2 results
  • Surgical Outcomes of Patients with Marfan Syndrome Complicated by Type A Aortic Dissection

    Abstract: Objective To evaluate surgical outcomes of patients with Marfan syndrome (MFS) complicated by type A aortic dissection (AAD) during follow-up. Methods We retrospectively reviewed clinical data of 44 patients with MFS complicated by AAD who were admitted to Wuhan Asia Heart Hospital from January 2006 to January 2012. There were 31 male patients and 13 female patients with their age of 12-54 (33.0±9.8) years. Twenty-three patients underwent Bentall procedure at different time after the onset of AAD, while the other 21 patients received conservative treatment in stead of surgery because of economical or other reasons. COX regression with time-varying covariates was performed to analyze related factors, using primary end point, primary end point+secondary end point as the outcome variables respectively, to compare postoperative outcomes and quality of life between the surgical treatment patients and conservative treatment patients. Results Postoperatively 1 patient died of multiple organ failure, and the other 22 patients survived the surgery. All the 43 patients were followed up from 1 to 75 months. The 3-year survival rate of the 22 surgical treatment patients was 95.7%, and they all had a good quality of life during follow-up. The survival condition and quality of life of the 21 conservative treatment patients was poor, and 13 patients (61.9%) died with the 3-year survival rate of only 31.7%. The main causes of their death included acute cardiac tamponade, aortic dissection rupture, acute myocardial infarction andcardiogenic shock. COX regression with time-varying covariates showed that the treatment outcomes of the surgical treatment patients were statistically different from those of the conservative treatment patients after modifying the influence caused by different operating time (OR of T_COV_ =0.088, P=0.028) . The risk of death of surgical treatment was only 8.8% of that of conservative treatment. Conclusion The prognosis of patients with MFS complicated by AAD is very poor. Therefore, all these patient, both in acute stage and chronic stage, should undergo surgical treatment as early as possible. The short-term and follow-up outcomes of surgical treatment are satisfactory.

    Release date:2016-08-30 05:28 Export PDF Favorites Scan
  • 急性人工瓣膜功能障碍六例临床分析

    目的 探讨急性人工瓣膜功能障碍的早期诊断及合理治疗措施。 方法 回顾性分析2011年1月至2012年1月武汉亚洲心脏病医院6例急性人工瓣膜功能障碍患者的临床资料,其中男3例,女3例;年龄28~61岁。风湿性心脏瓣膜病5例,退行性心脏瓣膜病1例;行主动脉瓣置换术1例,二尖瓣置换术3例,二尖瓣、主动脉瓣双瓣膜置换术2例。心瓣膜置换术后2个月~8年8个月出现急性人工瓣膜功能障碍,6例患者入院后均在24 h内因心力衰竭表现难以纠正而行气管内插管+有创呼吸机治疗;4例患者于入院后24 h内行急诊外科手术治疗,2例患者放弃手术治疗。 结果 人工瓣膜的主要病理改变为血栓形成、瓣膜赘生物形成、组织水肿、内膜增生和瓣叶活动度降低。经手术治疗的4例患者无围术期死亡,均痊愈出院;未行手术治疗的2例患者均于48 h内死于心力衰竭 。随访4例,随访时间12~23个月,随访期间4例患者均酌情服用利尿剂、血管紧张素转换酶抑制剂、华法林等药物,术后3个月、6个月、1年复查心脏超声心动图提示人工瓣膜功能良好,术后1年患者心功能均恢复至Ⅰ~Ⅱ级。 结论 急诊床旁经胸超声心动图检查对急性人工瓣膜功能障碍的早期诊断有重要的价值;尽早行外科手术治疗是挽救该类患者生命最有效的手段。

    Release date:2016-08-30 05:45 Export PDF Favorites Scan
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