使用差异化手术策略进行大动脉的修复
Frank Langer1, Diana Aicher, Anke Kissinger
1Department of Thoracic and Cardiovascular Surgery, University Hospitals Homburg, Homburg, Germany.
Circulation
|September 15, 2004
概括
大动脉修复对于由复杂的门或根问题引起的大动脉吐 (AR) 有效. 与门更换相比,这种定制方法提供了较低的死亡率和良好的中期耐用性.
科学领域:
- 心血管外科心血管外科
- 心脏门维修 心脏门维修
- 大动脉反治疗治疗
背景情况:
- 大动脉反 (AR) 由于孤立或联合的尖端和根部病理,提出了复杂的挑战.
- 系统的,个性化的修复策略对于成功的大动脉重建至关重要.
研究的目的:
- 评估针对AR的定制大动脉门修复方法的可行性和结果.
- 评估与个性化大动脉门修复相关的中期耐用性和发病率.
主要方法:
- 在1995年至2003年期间,在282名AR患者中进行了大动脉修复.
- 手术技巧包括根修复 (复制,替换,重塑,再植入) 和尖端修复 (复制,切除,补丁关闭).
- 收集了8425个患者月的随访数据,完整度为99.6%.
主要成果:
- 医院死亡率为3.9% (11名患者),复发性AR的再手术为3.3% (9名患者).
- 对于门修复,五年无AR等级>或=II的自由率为81%,对于根部置换,为84%,对于联合手术,为94%.
- 对于门修复,根部置换和联合手术,五年无需重新操作的时间分别为93%,95%和98%.
结论:
- 大动脉的修复是复杂的AR机制的可行选择,使用系统的,量身定制的策略.
- 该程序表明手术死亡率低,并鼓励中期耐用性.
- 与大动脉置换相比,与门相关的发病率明显较低.
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