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对慢性大动脉解剖和动脉瘤的开放胸腔腹部修复进行比较
Ian O Cook1, Susan Y Green2, Kimberly R Rebello1
1Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX.
Journal of vascular surgery
|March 27, 2024
概括
在慢性剖析患者中,胸腔腹腔大动脉动脉瘤 (TAAA) 的开放性手术修复显示了较低的手术死亡率和不良事件. 然而,这些患者需要长期监测进展性大动脉疾病.
科学领域:
- 心血管外科心血管外科
- 大动脉动脉瘤修复修复
- 胸前大动脉疾病 胸前大动脉疾病
背景情况:
- 大动脉解剖是患有胸腔腹腔大动脉动脉瘤 (TAAA) 开放性手术修复的患者的常见并发症.
- 慢性剖析通常与渐进性大动脉扩张有关,但当代结果并未得到充分理解.
研究的目的:
- 为了比较慢性剖析与非剖析动脉瘤患者的开放TAAA修复之间的患者特征和结果.
- 在TAAA修复中确定手术死亡率和不良事件的预测因素.
主要方法:
- 追溯分析3470个开放的TAAA维修.
- 慢性剖析 (n=1119) 和非剖析动脉瘤 (n=2351) 组之间的结果 (手术死亡率,不良事件) 的比较.
- 使用后勤回归和时间到事件分析来评估预测因素和生存率.
主要成果:
- 患有慢性剖析的患者年轻,风险因素较少,并且更有可能患有遗传性胸前大动脉疾病.
- 在慢性剖析组中,手术死亡率 (7.1% vs 9.2%) 和不良事件 (13.0% vs 15.8%) 较低.
- 慢性解剖本身并不能预测手术死亡率或不良事件;紧急修复,慢性病,II度TAAA修复,年龄和交叉时间是预测因素.
结论:
- 在慢性剖析中开放的TAAA修复与低的手术死亡率和不良事件率有关,包括持续的.
- 虽然晚期存活是合理的,但患有慢性剖析的患者在进展性大动脉疾病后期修复的发生率更高.
- 强大的长期成像监测对于在慢性剖析患者中管理渐进性大动脉疾病至关重要.
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