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昇動性大動脈と大動脈のアーチの165の動脈瘤で10年間の手術経験

A C Galloway¹, S B Colvin, C L LaMendola

¹Department of Surgery, New York University Medical Center, NY 10016.

|September 1, 1989

まとめ

上昇大動脈と大動脈動脈瘤の手術技術は改善され,病院での死亡率は17.9%から12.3%に減少しました. グラフトインクルージョンや循環停止などの進歩は,複雑なケースにもかかわらず,結果を改善しました.

科学分野:

心血管外科手術についてです.
胸部外科手術について
血管外科血管外科

背景:

昇動性大動脈と大動脈のアーキの動脈瘤は,重大な外科的課題をもたらす.
1978年から1988年の間に治療を受けた165人の患者の遡及的分析.

研究の目的:

昇動性大動脈と大動脈動脈瘤の手術結果を分析する.
外科技術における動向と改善,およびその死亡率と罹病率への影響を特定する.

主な方法:

上昇大動脈と大動脈動脈瘤の手術を受けた165人の患者の遡及的レビュー.
エチオロジーの分析,併用処置,外科的手法 (移植挿入,循環停止,ヘミアーク修復),および結果 (死亡率,脳卒中).

主要な成果:

研究期間中に病院での死亡率は17.9%から12.3%に減少したが,症例の複雑性が増加した.
手術による死亡率は,上昇大動脈矯正 (7.6%),弁管矯正 (5.3%),オープンヘミアーチ矯正 (8.8%),広範囲アーチ/下降大動脈矯正 (30.8%) により異なる.
年齢と動脈動脈瘤が下下大動脈または大動脈の関節への拡張は,手術リスクの増加の有意な予測要因でした. 脳卒中の発生率は2.4%でした.

結論:

移植入植と循環停止を含む外科技術の重要な進歩は,大動脈動脈瘤の修復の結果を改善しました.
複雑性が高まっているにもかかわらず,手術による死亡率は減少しており,進化する外科戦略の有効性を強調しています.
動脈瘤の拡張と患者の年齢は,大動脈瘤の修復における手術リスクに影響を与える重要な要因です.

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