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Resultados de la gestión médica de la disección aórtica aguda tipo B
Anthony L Estrera1, Charles C Miller, Hazim J Safi
1Department of Cardiothoracic and Vascular Surgery, The University of Texas-Houston Medical School, Memorial Hermann Heart and Vascular Institute, 6410 Fannin St, Suite 450, Houston, Texas 77030, USA. Anthony.l.estrera@uth.tmc.edu
Circulation
|July 6, 2006
Resumen
La gestión médica para la disección aórtica aguda tipo B muestra resultados aceptables, con una mortalidad hospitalaria del 10,1%. Se necesitan más comparaciones con otras estrategias como la colocación de stents endovasculares.
Área de la Ciencia:
- Cirugía cardiovascular La cirugía cardiovascular es una cirugía cardiovascular.
- Cirugía vascular Cirugía vascular.
- Cirugía torácica cirugía torácica.
Sus antecedentes:
- Se debate el tratamiento óptimo para la disección aórtica aguda tipo B.
- Este estudio informa de los primeros resultados clínicos de la gestión médica para esta condición.
Objetivo del estudio:
- Evaluar la efectividad del tratamiento médico para la disección aórtica aguda tipo B.
- Para comparar los resultados de la gestión médica con las intervenciones quirúrgicas.
Principales métodos:
- Una cohorte de 129 pacientes con disección aórtica aguda tipo B fue administrada médicamente entre 2001 y 2005.
- La intervención quirúrgica estaba reservada para indicaciones específicas como ruptura, expansión, perfusión o dolor intratable.
- Los pacientes fueron seguidos después del alta para evaluar los resultados.
Principales resultados:
- La mortalidad hospitalaria fue del 10,1% en general, con un 8,3% para los pacientes administrados médicamente y un 19% para los que requirieron intervención.
- La morbilidad incluyó ruptura (4,7%), accidente cerebrovascular (4,7%), paraplejía (8,5%), isquemia intestinal (7%), insuficiencia renal aguda (21%) y necesidad de diálisis (13%).
- Los factores de riesgo independientes para la mortalidad hospitalaria incluyeron la ruptura, mientras que la muerte a medio plazo se asoció con EPOC y baja tasa de filtración glomerular.
Conclusiones:
- El manejo médico de la disección aórtica aguda tipo B se asocia con resultados tempranos aceptables.
- Se necesita más investigación para comparar estos resultados con estrategias alternativas como la colocación de stents endovasculares.
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