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老年患者的大动脉动脉瘤的整体门置换与混合手术:回顾性队列分析
Kyungsub Song1, Yun Seok Kim1, Woo Sung Jang1
1Department of Thoracic and Cardiovascular Surgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea.
Journal of thoracic disease
|September 11, 2023
概括
对于患有大动脉动脉瘤的老年患者来说,混合手术在全门置换 (TAR) 上没有表现出优势. 然而,混合程序的再干预率更高,这表明在某些情况下,TAR可能更可取.
科学领域:
- 心血管外科心血管外科
- 血管外科 血管外科
- 胸部外科手术 胸部外科手术
背景情况:
- 患有大动脉动脉瘤的老年患者缺乏足够的证据来比较混合手术和全门置换 (TAR).
- 这项研究追溯分析了75岁以上接受大动脉动脉瘤修复的患者的结果.
研究的目的:
- 为了比较总门置换 (TAR) 与老年患者 (≥75岁) 的大动脉动脉瘤混合程序的术前结果.
- 为了确定这一患者队列中死亡的风险因素.
主要方法:
- 在2012年1月至2021年5月期间,对90名患者 (28名混合,62名TAR) 进行了多中心回顾性研究.
- 使用多变量分析评估术前结果和死亡风险因素.
- 随访时间平均为27.0±28.8个月.
主要成果:
- 混合体和TAR组之间在术后并发症或住院死亡率上没有显著差异.
- 在两组之间观察到类似的生存率 (P=0.31).
- 与TAR相比,混合程序的再干预率显著更高 (1,3,5年无需再干预:90%,80%,80%与100%相比,93%,93%;P=0.04).
结论:
- 混合手术在老年患者的大动脉动脉瘤中并不比TAR具有绝对优势.
- 与混合程序相关的更高的重新干预风险值得考虑.
- 手术策略的选择应根据患者的人口统计和解剖学进行个性化.
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