肺动脉室内血瘤对急性A型大动脉剖析患者的影响
Lizhi Lv1,2, Cheng Wang2,3, Xinyue Lang4
1Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
European radiology
|May 22, 2024
概括
肺动脉内腔血瘤 (PA-IMH) 在急性斯坦福型A大动脉剖析 (ATAAD) 中很常见,并增加了早期死亡率. 然而,PA-IMH在从医院出院的患者手术修复后不会影响长期存活率.
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
- 血管外科 血管外科
背景情况:
- 肺动脉静脉内血瘤 (PA-IMH) 是一种罕见的发现,在急性斯坦福型A大动脉剖析 (ATAAD) 患者中发现.
- 在手术修复ATAAD后,PA-IMH对短期和长期结果的影响尚不清楚.
研究的目的:
- 研究PA-IMH在手术修复后ATAAD患者的短期和长期影响.
- 确定患有PA-IMH相关不良结果风险较高的患者子组.
主要方法:
- 在2010年至2021年间经过手术修复的连续ATAAD患者的回顾性审查.
- 根据沿肺动脉延伸的出血来确定PA-IMH组.
- 使用多变量逻辑回归和卡普兰-梅尔生存分析.
主要成果:
- 在2046名ATAAD患者中,PA-IMH在15.8%的患者中被发现.
- PA-IMH与早期死亡率的增加有关 (9.3%对5.6%,OR=1.86,p=0.006),特别是在老年患者 (>70岁) 和DeBakey II型剖析患者中.
- 在手术后30天的基准分析后,在PA-IMH和非PA-IMH组之间没有观察到长期结果的显著差异.
结论:
- 在ATAAD患者中,PA-IMH是常见的发现,是术后修复早期死亡率增加的独立预测因子.
- 帕-IMH对死亡率的不良影响主要局限于早期的术后期.
- 在最初的出院后幸存下来的患者中,长期预后不会显著受到影响,这表明PA-IMH可能不会影响长期生存.
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