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Circulation:外科主动脉瓣置换术后临床卒中常见

2014-04-04 高晓方 译 医学论坛网

美国一项研究表明,外科主动脉瓣置换(AVR)术后临床卒中发生率高于既往胸外科学会(STS)所报告的,并且超过半数患者可在AVR后检出隐匿性脑梗死;AVR术后卒中的并发症与住院时间和死亡率增加有相关性。论文于4月1日在线发表于《循环》(Circulation)。 此项研究共纳入196例因钙化性主动脉狭窄而接受AVR治疗的患者。神经科医生在术前和术后对受试者进行评估,并在术后实施MRI检查。受试者平

美国一项研究表明,外科主动脉瓣置换(AVR)术后临床卒中发生率高于既往胸外科学会(STS)所报告的,并且超过半数患者可在AVR后检出隐匿性脑梗死;AVR术后卒中的并发症与住院时间和死亡率增加有相关性。论文于4月1日在线发表于《循环》(Circulation)。

此项研究共纳入196例因钙化性主动脉狭窄而接受AVR治疗的患者。神经科医生在术前和术后对受试者进行评估,并在术后实施MRI检查。受试者平均年龄为75.8 ± 6.2岁,女性占36%,非白人受试者占6%。

结果显示,临床卒中、短暂性脑缺血发作和院内死亡的发生率分别为17%、2%和5%。在STS数据库中,该人群的卒中发生率为7%。大部分卒中为轻度,中位NIHSS为3。临床卒中与住院时间延长具有相关性,中、重度卒中则与院内死亡显著相关。在术后接受MRI检查的109例无卒中受试者中,59例(54%)检出隐匿性梗死。隐匿性梗塞与院内死亡或住院时间延长均无相关性。

原始出处:


Messé SR1, Acker MA, Kasner SE, Fanning M, Giovannetti T, Ratcliffe SJ, Bilello M, Szeto WY, Bavaria JE, Hargrove WC 3rd, Mohler ER 3rd, Floyd TF; for the Determining Neurologic Outcomes from Valve Operations (DeNOVO) investigators.Stroke after Aortic Valve Surgery: Results from a Prospective Cohort.Circulation. 2014 Apr 1. 

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    2014-11-21 yxch48
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