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急性B型 (DeBakey III) 大動脈解剖患者のアウトカム: 13年間の単一センターでの経験
Rana O Afifi1, Harleen K Sandhu1, Samuel S Leake1
1From the University of Texas Medical School at Houston and Memorial Hermann Heart & Vascular Institute, Houston.
Circulation
|August 26, 2015
まとめ
急性B型大動脈解剖 (ATBAD) の結果は合併症に依存する. 合併症のあるATBAD患者では生存率が低下したが,合併症のないATBAD患者でも遅い症状の監視が必要である.
科学分野:
- 心血管外科
- 血管 外科
- 大動脈 疾患
背景:
- 大動脈の解剖は 常見の大動脈損傷です
- B型急性大動脈解剖 (ATBAD) の管理は,内血管の時代に進化しています.
研究 の 目的:
- 13年間治療されたATBAD患者の長期的なアウトカムを評価する.
- 疾患状態 (合併症と非合併症) と治療方法に基づくアウトカムを比較する.
主な方法:
- 442人のATBAD患者 (2001年−2014年) の遡及レビュー
- ATBADの分類は,合併症 (破裂,膨張,痛み,失血) と不合併症に分類される.
- カプラン- メイヤーと記述的統計を用いた無介入と全生存の分析
主要な成果:
- 合併症のないATBAD (uATBAD) は60. 6%で,合併症のあるATBAD (cATBAD) は39. 4%でした.
- 5年の無介入生存率はuATBAD群で62. 7%で,cATBAD群では42. 5%から47. 2%であった.
- 全体生存率は,合併症の呈現と有意に関連していました.
結論:
- ATBADの早期と後期の結果は,合併症の存在によって影響されます.
- uATBADは早期生存率が好ましいが,遅い合併症は監視と潜在的な介入を必要とします.
- uATBADの治療を最適化するためにさらなる研究が必要である.
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