在急性A型剖析修复后的第二大动脉手术的指示和结果
Mohammed Morjan1,2, Carlos-A Mestres1, Vedran Savic1
1Department of Cardiac Surgery, University Hospital Zürich, Zürich, Switzerland.
Interdisciplinary cardiovascular and thoracic surgery
|April 30, 2024
概括
一小部分患有急性A型大动脉解剖 (ATAD) 的患者需要进行第二次大动脉手术,通常是由于线脱落或门扩张. 延长的初始手术可能会减少重新手术的需要.
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
- 大动脉剖析研究研究
背景情况:
- 并非所有急性A型大动脉剖析 (ATAD) 病例都接受大动脉门或根部置换.
- 一些患者需要随着时间的推移进行第二次大动脉手术.
- 这些次要程序的迹象和结果需要进一步调查.
研究的目的:
- 分析需要在初始ATAD修复后进行第二次大动脉手术的患者的特征和结果.
- 识别与需要重新操作相关的因素.
主要方法:
- 对638名因ATAD而接受手术修复的患者进行了回顾性分析.
- 在随访期间确定需要第二次大动脉手术的患者.
- 式与非式程序的子组分析.
主要成果:
- 8%的患者需要进行第二次大动脉手术,最常见的是痕脱光 (44%) 或门扩张 (24%).
- 住院死亡率为12%. 在第一个手术期间孤立的上升性大动脉置换与第二次手术的发生率更高有关.
- 离患者的住院死亡率较低 (7.7%),但需要第二次干预的可能性更高.
结论:
- 在最初的ATAD手术期间,扩展的大动脉根手术和定制的大动脉门修复可能是有益的.
- 这些方法可能会降低与高风险的第二大动脉手术相关的发病率和死亡率.
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