在A型大动脉剖析中,严重的手术前条件是否是大动脉节省再植入的禁忌?
Joël Lapeze1, Jacques Robin2, Jean Ninet2
1Department of Cardiovascular Surgery, Infirmerie Protestante, Caluire et Cuire, France.
The Journal of cardiovascular surgery
|February 1, 2024
概括
动脉节约根部重建在A型动脉剖析 (TAAD) 中是可行的和安全的,即使是在严重的手术前条件下. 这种手术方法为TAAD患者提供了可接受的结果,对于70岁以上的患者建议谨慎使用.
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:
- 对A型大动脉解剖 (TAAD) 的手术管理仍然是持续辩论的主题.
- 这项研究评估了TAAD患者的大动脉节约根重建 (AVSR) 程序.
研究的目的:
- 为了证明TAAD的AVSR程序的可行性和安全性.
- 评估患有严重手术前疾病的患者的结果,包括输血阻塞和休克.
主要方法:
- 在2000年5月至2014年6月期间,对92名连续接受TAADAVSR治疗的患者进行了回顾性审查.
- 收集的数据包括手术前的情况,手术时间 (交叉紧,心肺绕道,循环停止) 和医院死亡率.
主要成果:
- 医院死亡率为16.3%,平均随访时间为27.6个月.
- 一年后的保险学生存率为82.5%. 由于大动脉功能不充分而进行了一次早期的重新手术.
- 在不同患者群体中,死亡率和发病率是可比的.
结论:
- 在TAAD患者中可以进行AVSR,无论手术前的输血或休克,手术后的结果是可以接受的.
- 建议在接受这种手术的70岁以上的患者要小心.
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