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术前D-二次体与形态特征和急性A型大动脉剖析手术结果之间的关联

Shuanglei Zhao¹, Zhou Liu¹, Mingxiu Wen¹

¹Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

Interdisciplinary cardiovascular and thoracic surgery

|November 21, 2024

概括

术前的D-二次体水平与大动脉剖析的程度和急性A型大动脉剖析患者的不良外科结果相关. 较高的D-二次数表明疾病更严重,手术后风险增加.

科学领域:

心血管外科心血管外科
血管医学血管医学
诊断生物标志物诊断生物标志物

背景情况:

术前D-二次体水平与急性A型大动脉剖析 (aTAAD) 的形态特征和手术结果之间的关系仍然不完全理解.
准确评估TAAD的严重程度对于手术规划和预测患者预后至关重要.

研究的目的:

调查手术前D-二次体水平与剖析程度,分支动脉 perfusion 和主要不良事件 (MAE) 之间的关联,在患者接受了 aTAAD 的冷大象干 (FET) 完全门置换.
为了确定D-二次体是否可以作为计算机断层扫描血管学 (CTA) 的补充标记物,用于评估aTAAD的严重程度.

主要方法:

一项回顾性研究包括了430名患有aTAAD的患者,他们接受了整体门置换和FET.
患者被分为较高 (>2307 ng/ml) 和较低 (≤2307 ng/ml) 的D-二次体组.
限制立方线模型评估了D-二次体和剖析程度,分支动脉 perfusion 和MAEs之间的关联.

主要成果:

较高的D-二次体水平与更多的剖析延伸长度和多个大动脉段的虚假光线周长度有关.
具有较高D-二次数的患者在特定的分支动脉中表现出增加的阻 perfusion,以及较高比例的切割的肋间动脉.
在D-二分体和剖析程度之间发现了非线性关联,而在D-二分体和MAE之间观察到线性关联,在调整CTA发现后仍然显著.

结论:

手术前的D-二分体是剖析程度和MAE的强有力的积极预测因子,在接受FET全门置换的aTAAD患者中.
D-二聚体可以作为CTA的一个有价值的辅助物,用于量化大动脉解剖的严重程度.
升高的D-二次体水平表明aTAAD中不良外科结果的风险更高.

关键词:

急性A型大动脉切割 D-二聚子 D-二聚子主要不良事件主要不良事件形态特征形态特征形态特征手术手术手术术术

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