大动脉根动脉瘤的手术:30年的经验
Kenton J Zehr1, Thomas A Orszulak, Charles J Mullany
1Division of Cardiovascular Surgery, Mayo Clinic, 200 First St SW, Rochester, Minn 55905, USA. zehr.kenton@mayo.edu
Circulation
|August 18, 2004
概括
动脉瘤的前动脉根置换显示出较低的死亡率和发病率. 复合管和门保护重建都提供了持久的结果,重新操作通常与门故障或其他大动脉问题有关.
科学领域:
- 心血管外科心血管外科
- 胸部外科手术 胸部外科手术
- 大动脉外科手术
背景情况:
- 涉及大动脉根的动脉瘤需要手术干预.
- 评估了大动脉根置换和门保护重建的长期结果.
研究的目的:
- 评估大动脉根置换和膜保护大动脉根重建的长期结果.
- 为了比较复合管和门保护技术之间的结果.
主要方法:
- 在1971年至2000年间对203名接受大动脉根手术的患者进行了回顾性分析.
- 患者接受了复合管重建 (149) 或门保护重建 (54).
- 在50名患者中存在马方综合征.
主要成果:
- 住院/30天死亡率总体为4.0%,这两种手术的死亡率相似.
- 20年时保险学生存率达到52%;20年时无需重新操作的生存率为72%.
- 晚期死亡的预测因素包括心肌吐和年龄较大;重新手术的预测因素包括马凡综合征和初始门保护重建.
结论:
- 对动脉瘤进行大动脉根置换可以在较低的发病率和死亡率下进行.
- 复合管道重建提供了持久的结果,抗凝或假的并发症很少.
- 重新手术通常是由于大动脉的衰竭或其他心脏/大动脉疾病而需要的,特别是在门保护程序后.
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