在急性A型大动脉剖析手术后,复合根替换用生物假体的早期手术结果
Yoshimasa Seike1, Kazunori Sakaguchi1, Kento Shinzato1
1Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, 6-1 Kishibe Shinmachi, Suita, Osaka, Japan.
General thoracic and cardiovascular surgery
|September 1, 2024
概括
在急性A型大动脉解剖 (AAAD) 修复后,用生物假体 (b-CVRR) 替代复合根,显示了可接受的外科结果. 冠状动脉事件与重建动脉的粘附有关.
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:
- 急性甲型大动脉解剖 (AAAD) 带来了重大的外科手术挑战.
- 在AAAD修复后,大动脉根和门的重建是至关重要的.
- 在这种情况下,用生物假体 (b-CVRR) 替代复合根是一种复杂的程序.
研究的目的:
- 为了评估b-CVRR在之前接受AAAD修复的患者的外科结局.
- 在AAAD之后确定与b-CVRR相关的指示和并发症.
主要方法:
- 在AAAD修复后接受b-CVRR的41名患者的回顾性分析 (2007-2022年).
- 排除标准包括VSRR,机械使用,真菌动脉瘤和CPR.
- 详细评估手术指示,冠状动脉重建技术和结果.
主要成果:
- 对于b-CVRR的常见指示包括伪动脉瘤 (51.2%),严重的AI (46.3%),重新切割 (36.6%) 和根扩张 (41.5%).
- 采用了各种冠状动脉重建方法,而皮赫勒手术没有显示出血栓形成.
- 医院死亡率为7.3%,并发症包括肌性代谢综合征,心力衰竭和出血.
结论:
- 在AAAD修复后b-CVRR的手术结果被认为是可以接受的.
- 观察到手术内冠状动脉事件,主要是由于粘接而导致的狭窄.
- 谨慎的手术技术是必要的,以尽量减少复杂的大动脉重建的并发症.
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