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血管内动脉修复后A型大动脉解剖的手术治疗:一项为期12年的单中心研究

Yuan Xue^1,2,3, Shipan Wang^1,2,3, Xuehuan Zhang⁴

¹Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Street, Beijing, 100029, Chaoyang District, China.

Cardiovascular drugs and therapy

|March 15, 2024

概括

开放性修复是胸内血管大动脉修复 (TEVAR) 后A型大动脉剖析 (TAAD) 的可行的治疗方法,显示了可接受的结果. 对于TEVAR后的患者来说,由于TAAD风险增加,持续的随访至关重要.

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:

胸内血管大动脉修复 (TEVAR) 是对大动脉疾病的常见治疗方法.
在TEVAR后,可能会出现A型大动脉解剖 (TAAD) 等并发症.
对于这些复杂的案例,有时需要进行二次开放维修.

研究的目的:

为了研究TEVAR后TAAD患者的开放修复的临床结果.
为了比较逆行性TAAD (RTAD) 和近端新大动脉剖析 (PNAD) 组之间的结果.
评估TEVAR后开放性修复的长期疗效和安全性.

主要方法:

在TEVAR (2010年1月 - 2022年6月) 后接受开放修复的113名TAAD患者的回顾性分析.
根据解剖学,患者被分为RTAD (n=56) 和PNAD (n=57) 组.
使用卡普兰-梅尔曲线和日志等级测试进行生存分析.

主要成果:

30天死亡率为6.2%;1,5年和10年的总生存率分别为88.5%,88.5%和87.6%.
没有观察到与大动脉相关的晚期死亡;3名患者需要进一步的胸腔腹腔大动脉置换.
RTAD组的上升大动脉较小,近端着陆区域更接近,但两组之间没有生存差异.

结论:

在TEVAR后,TAAD是一种潜在的并发症,需要进行开放性修复.
开放性修复为TEVAR TAAD后的早期和中期结果提供了可接受的结果.
由于TAAD风险增加,建议对TEVAR患者进行强制性随访.

关键词:

靠近的新大动脉剖析.胸内血管大动脉修复总的门更换总量一种类型的甲动脉剖析.

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